Three Takeaways From ADA Clinical Updates: Turning Standards Into Practice
If you work in diabetes care and education and are a member of the American Diabetes Association, you’ve likely received the nearly 400-page Standards of Care journal in your mailbox.
What began as a three-page reference document in 1989 has grown into a comprehensive resource that now rivals a phonebook. The depth of guidance is incredibly valuable, but translating all of those standards into day-to-day clinical practice can feel a bit daunting.
Enter the ADA Clinical Updates Conference, an important piece of the puzzle that focuses on moving evidence off the page and into real-world care. After spending the weekend in Houston, here are my three key takeaways that will shape my consultative and clinical practice this year.
1. Seeing Is Believing in Clinical Practice
One of the strongest and most consistent messages this year was that seeing, and showing, is believing. A nearly 400-page reference manual can only take clinical practice so far if clinicians are not shown how to apply it. Seeing how a recommendation plays out for a real patient, with real constraints and competing priorities, is what moves standards from theory into meaningful clinical practice.
Across sessions, from automated insulin delivery in pediatrics to obesity care, MASH, pregnancy, and psychosocial support, the Standards of Care (SOC) were not simply reviewed. They were demonstrated. Speakers consistently grounded recommendations in practical, case-based scenarios that reflected real-world clinical decision-making.
This matters because we already know the challenge. Evidence can take years to reach patients, and even when it does, implementation is often inconsistent. The gap is rarely a lack of information. It is a gap in translation.
What This Means for Practice:
- Use case studies intentionally in team education, precepting, and clinician training.
- Start with one recommendation at a time and ask, “How would this look for a real patient on my schedule this week?”
- Build workflows that support implementation, not just documentation.
#2 Rethinking Obesity Metrics
With the launch of ADA’s new division, the Obesity Association, there was a clear emphasis on obesity as a chronic disease that requires long-term, person-centered care. Across sessions, medication options, follow-up timelines, wraparound support, and the expectation of ongoing, often lifelong, treatment were consistently reinforced.
At the same time, weight loss remains the dominant outcome metric. Much of the discussion continues to center on BMI and total weight change, with far less nuance given to body composition, fat distribution, and metabolic risk independent of weight.
One notable shift was the emphasis on waist-to-height ratio as a marker of cardiometabolic risk. A waist circumference greater than half of one’s height signals increased risk for diabetes, cardiovascular disease, and related conditions, regardless of BMI. This provides a more clinically meaningful way to discuss adiposity without defaulting to weight alone.
There is progress here, but framing matters. When weight loss is positioned as the primary goal, it can obscure what we are actually trying to improve: metabolic health and long-term risk reduction.
What This Means for Practice:
- Reframe obesity treatment goals around health gain, not weight loss alone.
- Incorporate measures such as waist circumference and cardiometabolic risk factors into routine assessment. Body composition assessments using tools such as InBody or DEXA provide even greater clinical insight.
- Be precise with language. Focus discussions on fat distribution, insulin resistance, liver health, and functional outcomes rather than weight alone.
#3 A Shift from Glucose-Centric to Cardio-Renal-Metabolic Care
While this shift has been gradual, beginning with the 2022 Standards of Care updates, it is time to move away from a glucose-centric model of diabetes care. Glycemia still matters, but it is no longer the singular pillar of treatment.
Instead, the emphasis is on cardio-renal-metabolic health, with cardiovascular risk, kidney disease, liver disease, obesity, and metabolic dysfunction recognized as interconnected conditions rather than secondary concerns.
Several sessions suggested that patients be stratified not only by A1c, but by overall cardiovascular and renal risk. Albuminuria, for example, was highlighted as a direct marker of kidney damage and an indirect marker of cardiovascular disease.
This shift also reframes success. A “good” A1c does not necessarily mean good health, and “poor glycemic control” does not imply “nonadherence”. Bias, misdiagnosis, access, psychosocial stress, and coexisting conditions all play a role
What This Means for Practice:
- Use a cardio-renal-metabolic framework to guide treatment decisions.
- Prioritize therapies that provide cardiovascular and renal protection.
- Treat the person, not just the glucose data.
A Note of Appreciation
I want to finish by acknowledging and expressing my deep gratitude to the ADA Women’s Interdisciplinary Network (WIN) Professional Development Program, which generously provided financial assistance, including registration and accommodations, as part of my participation in the program. They also hosted a working breakfast and dedicated sessions with ADA Scholars to help kick off the weekend.
Ready to Strengthen Diabetes Care and Education in Your Practice?
Are you looking to build, refine, or expand diabetes care and education services within your practice? I provide flexible, consultative support designed to meet the needs of busy clinics and healthcare organizations.
Diabetes care and education is central to my work. My approach focuses on translating current evidence and standards of care into clear, practical strategies that support sustainable behavior change and informed decision-making.
Let me help you develop patient-centered diabetes care and education that integrates seamlessly into clinical care. Book a discovery call to explore how we might work together.
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