August 11, 2025
6 min read
Key takeaways:
- Diabetes standards and guidelines have evolved greatly, but outcomes have improved at a slower pace.
- The ADA is working on ways to implement its Standards of Care into clinical practice.
The American Diabetes Association issues Standards of Care each year that inform clinicians of the optimal ways to care for patients with diabetes.
But the practice of taking care of patients is complicated, and not every clinician who cares for the diabetes population has time to read and memorize the Standards each year.

With that in mind, the ADA has been focusing on transforming the Standards of Care into routine clinical practice. Those efforts were the focus of a keynote address at the ADA’s Scientific Sessions by its chief quality officer, Osagie Ebekozien, MD, MPH, CPHQ.
“While our standards and our guidelines have evolved significantly, mortality from complications of diabetes has improved, but not at the same pace,” Ebekozien said during the keynote address. “There are still gaps in outcomes, by race, ethnicity, ZIP code and insurance. I am convinced we can do better, and I am looking forward to ongoing collaboration to transform and change this trend.”
Healio spoke with Ebekozien about the challenges of getting the Standards of Care implemented in everyday practice, initiatives that are being implemented to help clinicians and institutions follow the Standards of Care and how tools such as electronic health records and AI are helping in the effort.
Healio: What was the theme of your keynote address at the ADA Scientific Sessions?
Ebekozien: The ADA is recognizing the need for us to do more than just having good science and good research. All that is important; there are more than 2,000 different abstracts and research studies being presented here at ADA. But one of the things that we’re moving to do is, how do we take all this great research, all these great standards, and translate that to everyday practice and the primary care level and specialty care levels? And that’s the one piece I’m hoping to highlight to everyone: We’re going to need all of us to think beyond what is new and innovative, but to think about, how do we bring that into routine practice, which is something the ADA is very passionate about, and invest in a lot of resources. We’re looking to collaborate with everyone interested in this same mission.
Healio: What are some of the challenges in getting these standards into everyday practice?
Ebekozien: The Standards have evolved a lot over the years. You know, the very first set of guidelines in diabetes was published in 1989. Then, there were just six recommendations in three pages of content. Fast forward to 2025, and there are more than 600 recommendations for what diabetes management should look like, so the first challenge is management of diabetes is now more complex than it was 10 years ago, 20 years ago and especially 35 years ago, when the very first set of Standards were published. And to address the complexity of the Standards, what we’re doing at ADA is trying to streamline a lot of these Standards and identify the priority Standards as well, especially for primary care providers. Because we know that primary care providers care for 80% of people living with diabetes and obesity, the question is, can we simplify and reduce this voluminous 350 pages of guidelines into small, digestible chunks of key recommendations? And we’ve done that. The ADA now publishes an abridged Standards of Care that is available on the ADA website, diabetes.org, and our professional website, and that is a tool and a resource. Anyone not familiar with them can go login and take a look at the abridged Standards of Care, a valuable resource because there’s a lot of research and evidence that has informed it. While one of the biggest barriers to implementation is that there are a lot of recommendations, we have been streamlining that to more digestible information sets.
Healio: What sort of programs does the ADA have to help institutions implement the Standards of Care?
Ebekozien: Institutions reach out to ADA all the time about this; we can be contacted at quality@diabetes.org. What typically happens when institutions reach out to us is we try to understand what are the pain points they have now, and where those institutions are. We have a lot of different programs. There are 22 different guideline implementation projects happening all across the country. Our projects range from helping to implement diabetes technology standards based on the 2025 guidelines, to screening for type 1 diabetes to managing inpatient diabetes.
We typically want to understand where are the gaps the health system is facing. We have that conversation, look at some of their preliminary data. ADA has a team of coaches and practice facilitators that can come over to your practice or interact virtually. And more importantly, we connect health systems and primary care centers with their peers that are already doing great things in that area. We connect them together for peer-to-peer learning, peer-to-peer landmarking. We have a robust educational component to our work, and that’s all free and publicly available with the Institute of Learning, which can be found on the ADA’s website. So, it’s a collaborative approach we take. Our goal is we want to improve outcomes. We want to improve access. We want everyone caring for people with diabetes today to ensure that they’re using the best available evidence and recommendations as of today. Our goal is to close this gap. We are more than happy to collaborate with anyone.
Healio: Are there any initiatives coming down the road that may further help in this area?
Ebekozien: Yes, there are, so I’ll highlight a few things. The first is we are in partnership with a lot of major stakeholders, including electronic health record companies. We are having conversations with them on how can we take a lot of our standards and incorporate that into the overall health system. There are a few health systems that have already done this. We’re trying to see, how can we scale an approach like that? So that’s still early on, but we are paying a lot of attention to it and investing in it.
If we can automate the availability of the Standards on the EHR system, we know that that will also help amplify that because we want to get this into the EHRs of primary care providers, endocrinologists and diabetes specialists to reduce the amount of time and money needed to take for them to have the information they need. And we’re also collaborating with a lot of data aggregators as well, to understand how do we use artificial intelligence. How do we use real-world data, big data in the diabetes space, and to look at where we have bright spots for where the Standards are already being implemented in the appropriate way. And how do we help use AI to scale the adoption of the Standards as well.
We are also working with a lot of community partners to think about the role of the broader social community and network, including virtual care, and how virtual care can support specialist care, and how specialist care can support primary care. We’re taking a holistic approach to this to ensure that irrespective of where people are, what their community looks like where the patient is receiving care, or where they are going to receive that care, that they all have a chance at ensuring that they are receiving care based on the new Standards and the new guidelines.
The ADA is also investing in research in the type 1 diabetes and type 2 diabetes spaces. We feel very optimistic that if we can address a lot of the barriers and reduce a lot of the inertia, that would help improve outcomes. We want to continue to promote understanding of the state of outcomes and how can we work together to continue to further drive improvements in those outcomes, and close gaps in care as well.
Healio: Is there anything else you would like to mention?
Ebekozien: It’s going to take all of us. If you have ideas on or ways that you’ve tried in the past that has helped bring the Standards into practice, we want to hear about that as well. You can reach out to us at quality@diabetes.org. If you are a partner that also wants to collaborate on some of these things we talked about, we welcome that. It truly is going to take all of us together to move the needle. We welcome any opportunities to collaborate and work together, because it’s going to take everyone to be in this fight to improve outcomes for people with type 1 diabetes, type 2 diabetes and obesity.
Reference:
- Ebekozien O. Keynote address — From standards of care to standards of practice. Presented at: American Diabetes Association Scientific Sessions; June 20-23, 2025; Chicago.
For more information:
Osagie Ebekozien, MD, MPH, CPHQ, can be reached at oebekozien@diabetes.org or on X @ebekozien.