Updated standards of care for diabetes
To inform your metabolic health strategy
Lia Gass Rodriguez, MD, FAAP, Chief Medical Officer, CVS Healthspire Payor Solutions
The American Diabetes Association (ADA) recently released its 2025 Standards of Care.1 The updated guidelines bring a fresh focus on diabetes monitoring and treatment, with a stronger call to action to address weight as a key risk factor for the condition. It’s important to understand what these changes could mean for your plan members who have or are at risk for diabetes – and what these updates might mean for your metabolic health strategy.
New diabetes guidelines at a glance
Notable updates to the guidelines include:
- Earlier initiation of continuous glucose monitoring (CGM) people with diabetes – as soon as at the time of diagnosis for some patients2
- Proactively addressing obesity and overweight to help treat and prevent type 2 diabetes, with a personalized approach to weight management3
- Guidance on using pharmacotherapy, including GLP-1s, in patients with type 2 diabetes for kidney and heart health
Early utilization of continuous glucose monitoring
New guidelines recommend early utilization of continuous glucose monitoring (CGM) for people with diabetes – potentially as soon as the time of diagnosis. Previously, CGM was primarily recommended for patients with type 1 diabetes or those with significant hypoglycemia. However, the ADA now suggests CGM can be beneficial for a broader range of patients, including those with type 2 diabetes who are using insulin or other glucose-lowering medications.2
CGM is a more advanced and effective method for managing blood sugar levels than blood sugar monitoring via daily finger prick tests. CGM uses a small device that applies to the skin to continually detect glucose levels. This type of monitoring provides real-time data and trends, offering a more comprehensive view of how factors such as diet, exercise and medication affect blood sugar.4
When clinically appropriate, starting CGM at the point of diagnosis can help patients gain better control over their condition from the very beginning. This proactive approach not only helps in managing diabetes more effectively but also empowers individuals to make informed decisions about their daily activities and lifestyle choices.
Our Transform Diabetes Care program can help identify members who might benefit from CGM versus self-monitoring. The personalized and member-centered program also includes functionality to connect with CGM devices to track and share glucose levels with program clinicians to help guide individualized diabetes management.
Weight management to prevent and treat type 2 diabetes
Lifestyle changes remain a cornerstone of diabetes prevention and management. The updated guidelines highlight the critical role of achieving and maintaining a healthy weight, with nutrition and exercise as essential components toward better metabolic health. Losing even 5-10% of body weight can have a profound effect on overall health. For many individuals, this modest weight loss can lead to improved glycemic control and a reduced need for medication.5
Gone are the days of one-size-fits-all approaches. The guidelines now recommend personalized nutrition plans tailored to individual needs, preferences and health conditions. Now, health care providers are encouraged to tailor treatment strategies to the unique needs and circumstances of each patient, including personal and cultural preferences, as well as social determinants of health. This means considering factors such as lifestyle, comorbidities and individual health goals to create a more effective and sustainable management plan. A personalized approach helps ensure dietary changes are effective, enjoyable and maintainable over the long term.
The CVS Weight Management™ program is uniquely suited to fit these new guidelines, with personalized nutrition planning from a dedicated registered dietitian, ongoing support through live chats and self-service tools, all available through a virtual care model to broaden access even to individuals who are unable to access in-person weight management support. The program can help support members with or without weight management medication – and even can help members who choose to discontinue weight management medication to safely titrate off their prescriptions.
Expanding indications for metabolic health medications
The ADA also included updated guidance on pharmacotherapy, including expanded indications for GLP-1s and SGLT-2 inhibitors to promote better cardiovascular and kidney health in patients with type 2 diabetes.7, 8 As indications continue to expand for these and other drug classes, it will be important for plan sponsors to keep an eye on the drug pipeline and adjust their coverage strategies accordingly.
While the evolving metabolic health landscape can seem overwhelming, we’re keeping a close eye on the latest clinical and pharmacological developments. Let us put our clinical and industry insights to work to help develop an approach that fits your coverage strategy and supports optimal outcomes for your plan members. For more information or to request an opportunity analysis, please contact your CVS Caremark account representative.
