In January, the American Diabetes Association (ADA) released its 2019 Standards of Care (SOC), detailing comprehensive updates to its guidelines for the prevention, treatment, and management of diabetes and its related risk factors. The ADA standards of care guidelines are important for health providers and patients alike, and provide us with the best methods for ensuring positive health outcomes and fulfilling, healthy lives for people living with diabetes.

The ADA 2019 SOC is a massive document that tackles every aspect of the delivery of care and management of diabetes and its related conditions, but there are several major takeaway updates.

Heart Health

In a first, the ADA partnered with the American Health Association to bring their recommendations in-line with up-to-date hearth health guidelines. This partnership was an effort to reduce deaths from heart disease, which top the list of causes of death for people living with diabetes. These recommendations include drugs that better fit patients with both diabetes and heart disease, lifestyle suggestions, and better routine screening for developing heart issues.

Dietary Improvements

Under the 2019 SCO, the guidelines for diets for people living with diabetes were comprehensively expanded to accommodate a wide range of dietary needs and individual preferences. For the first time, these dietary and meal-planning recommendations account for people with low-carb diets, people who are pregnant and/or lactating, people at-risk for eating disorders, and people with renal or heart disease. More individual customization was given to allow patients room to create the right diet for them and their daily lives.

Considerations for Older Adults Living with Diabetes

The ADA added a new section dedicated to the unique dietary and lifestyle needs of older adults, aged 65 and older, who are living with diabetes. This is an important addition as older adults face new concurrent health and daily living challenges as they age that need to be factored into any diabetes treatment and management strategy.

Furthermore, the 2019 SOC gives health providers the option of discussing de-intensification of insulin regimens with their older patients, giving power to patients who wish to utilize simpler insulin regimens and/or develop drug plans that better match their personal self-management of their daily health.


Telemedicine, a rapidly growing field of medicine where health providers digitally communicate with patients to monitor their health and conditions, was added to the SOC to help patients and their telemedicine providers better manage remote delivery of care and information about diabetes. Patients who find themselves living in remote locations should make full use of these new guidelines to seek telemedicine appropriate for their care and management of diabetes.

How These Recommendations Can Help Patients

The key patient takeaway from the ADA 2019 SOC is that patients have more control over the treatments and management strategies that they receive from their health providers. Things like patient motivation, personal preferences and self-management, quality of life, mental health, socioeconomic context, and other factors have been added to the wide range of things considered in care for diabetes. This is a big shift by the ADA towards more patient-centered, holistic care for people living with diabetes, and returns control to the hands of patients.

People living with diabetes should take the time to discuss these updates with their health providers, and find ways to adopt some of these updates to better customize their treatment and health management plans.

Taking Action on Insulin Costs

Advocating for patients and empowering patients to advocate for themselves are both important aspects of efforts improving our health care system. The ADA, as part of its 2019 SOC, updated their section on diabetes advocacy to acknowledge the decrease in access to insulin and its skyrocketing prices. The ADA created a working group in 2017 that analyzed all the issues with the US health care system that contribute to rising insulin costs. With as many as one in four patients with diabetes admitting to cutting down insulin use due to prices, it is critical that both health providers and patients alike find ways to combat these rising drug prices before more people living with diabetes find their condition unmanageable or life-threatening.

People living with diabetes who find themselves suffering from excessive insulin costs should urge their providers to take action on their behalf and contact their Congresspeople. The ADA’s Stand Up for Affordable Insulin campaign provides easy ways for both providers and patients to get involved with advocating for lower insulin prices.