Press release

Important Updates to the 2021 Standards of Medical Care in Diabetes Issued by American Diabetes Association Experts

June 16, 2021 | Arlington, Virginia

Today, the American Diabetes Association® (ADA) issued important updates to the 2021 Standards of Medical Care in Diabetes (Standards of Care), in annotations as the Living Standards of Care. Changes include new data on teplizumab and SGLT2 inhibitors as well as medications’ effects on patients with chronic kidney disease. These amendments were driven by recently published research and were crafted and approved by the ADA’s Professional Practice Committee, which is responsible for producing the Standards of Care. Updates to Section 10, Cardiovascular Disease and Risk Management, have also been reviewed and approved by the American College of Cardiology, which endorses this section. The Living Standards of Care are available immediately online at Diabetes Care®.

Updates to the Living Standards of Care include information added to the following sections:

  • Section 2. Classification and Diagnosis of Diabetes has been revised to include the evidence from a trial on anti-CD3 antibody, teplizumab, in relatives at risk for type 1 diabetes which demonstrated a delay in the development of type I diabetes.
  • Section 10. Cardiovascular Disease and Risk Management has been updated to include new evidence from cardiovascular trials, including the Evaluation of Ertugliflozin Efficacy and Safety Cardiovascular Outcomes Trial (VERTIS CV), the Effect of Sotagliflozin on Cardiovascular and Renal Events in Patients with Type 2 Diabetes and Moderate Renal Impairment Who Are at Cardiovascular Risk (SCORED) trial, the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure and a Reduced Ejection Fraction (EMPEROR-Reduced), and the Effect of Sotagliflozin on Cardiovascular Events in Patients with Type 2 Diabetes Post Worsening Heart Failure (SOLOIST-WHF) trial. 
  • Section 11. Microvascular Complications and Foot Care has been amended to include the new evidence from trials of medications that impact patients with chronic kidney disease: the Dapagliflozin in Patients with Chronic Kidney Disease (DAPA-CKD) study and the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease (FIDELIO-DKD) trial.  

“There have been so many exciting advancements in the field of diabetes and that is why we are publishing more frequent updates to the Standards of Care.  We are proud of the work done by our exceptional team of experts,” said Dr. Robert Gabbay, Chief Scientific and Medical Officer for the ADA. “The American Diabetes Association is committed to improving the lives of all those affected by diabetes through this publication of the most widely respected guidelines for diabetes health professionals and updates like these are part of that commitment.” 

The Standards of Care provides the latest in comprehensive, evidence-based recommendations for the diagnosis and treatment of children and adults with type 1, type 2, or gestational diabetes; strategies to improve the prevention or delay of type 2 diabetes; and therapeutic approaches that reduce complications and positively affect health outcomes. In 2018, the ADA began updating and revising the online version of the Standards of Care throughout the year, with annotations for new evidence or regulatory changes that merit immediate incorporation. The online version of the Standards of Care now includes any research updates or policy changes that are approved throughout 2021.

The complete, annotated Standards of Care, which includes updates made today, can be accessed online at Diabetes Care. The Abridged Standards of Medical Care in Diabetes has also been updated and can be accessed online at Clinical Diabetes.

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About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).