In 2025, the ADA reflects on decades of advancements in the understanding and treatment of diabetes.
This year, the American Diabetes Association is celebrating 85 years of national impact toward its vision of ‘a life free of diabetes and all its burdens’.
Prior to the mid-1900s, Americans with diabetes had no formal organization that was devoted to the health and research of their condition.
The American Diabetes Association was founded as a result in 1940 to improve the lives of those affected by diabetes, and ever since then has been advocating for and funding groundbreaking diabetes research and educating healthcare practitioners and patients on proper diabetes care.
Repertoire Magazine recently spoke to Dr. Rita Kalyani, chief scientific and medical officer at the American Diabetes Association, and Dr. Samar Hafida, vice president of the Obesity Association, a division of the ADA, about the anniversary of the organization and the strides that the medical community has made in diabetes knowledge in the past 85 years.
Impact of the ADA
Approximately 38.4 million Americans, or nearly 11.6% of the nation’s population, had diabetes in 2021, according to the ADA. And 1.2 million Americans continue to be diagnosed with diabetes every year.
Diabetes is a chronic condition impacting how the body uses glucose (sugar) for energy; if not managed properly, it has the potential to lead to serious health complications including heart, kidney and eye disease, nerve damage and more, according to the ADA.
For decades, the ADA has recognized the need for nationwide understanding of the condition among healthcare practitioners and has been pivotal in supporting the health journeys of people across the nation with diabetes.
In the past 85 years, the ADA has marked numerous important milestones in the advancement of diabetes care.
In 1952, the ADA Research Program was founded to support diabetes research aimed at saving lives and accelerating health breakthroughs.
“Since the early 1950s, the ADA has invested millions in research, driving discoveries that have transformed diabetes prevention, care and treatment,” said Dr. Kalyani. “This investment, together with that of the diabetes and research community at large, has helped yield landmark outcomes – such as in demonstrating the benefits of lifestyle changes in delaying the development of diabetes; advances in insulin delivery and continuous glucose monitoring; and breakthroughs in stem cell–derived beta cell replacement and precision medicine.”
In 1984, the first National Standards for Diabetes Self-Management Education and Support (DSMES), a comprehensive resource for achieving success in self-management and support were published, establishing a framework for high-quality diabetes education. Today, the ADA has the largest number of recognized DSMES programs available to people living with diabetes.
“Research is the cornerstone of advancing the mission of the American Diabetes Association,” said Dr. Kalyani. “While we have made significant progress, there is still much left to discover about diabetes. By supporting early career investigators, fostering the next generation of leaders, and funding investigator-initiated research, we aim to uncover discoveries that will advance care and treatment for people living with diabetes.”
In 2024, the ADA Research Program grew to manage 193 active awards and launched 51 new projects.
“One of the foundations of our current strategy is the Pathway to Stop Diabetes® program, which identifies and supports a new generation of innovative scientists and physicians,” said Dr. Kalyani. “Since its inception, Pathway has provided resources and mentorship to extraordinary individuals who are dedicated to prevention and to helping people with diabetes thrive.”
Advancing an understanding of diabetes
As the medical community’s understanding of diabetes continued to advance after the 1940s, healthcare practitioners treating the condition needed a systematic, reliable way to treat all their patients.
In response, in 1989, the ADA began publishing yearly Standards of Care in Diabetes, giving healthcare practitioners a definitive resource on best practices for diabetes care.
Through the efforts of the Professional Practice Committee (PPC), which includes volunteer experts from diverse professional backgrounds and physicians, nurse practitioners, certified diabetes care and education specialists and more, the Standards of Care in Diabetes are still updated annually with the latest breakthroughs in research.
The ADA’s Standards of Care have reshaped the way diabetes that is treated in the U.S., according to Dr. Kalyani.
“Today, in addition to glucose-lowering management approaches, care has broadened to address the whole person – cardiovascular health, kidney protection, weight, technology, and quality of life,” said Dr. Kalyani. “Just as importantly, they’ve highlighted prevention, regular screening, diabetes technology, and the need to address health access. In many ways, the Standards have become the roadmap for consistent, evidence-based and person-centered diabetes care.”
The Standards of Care have continued to impact the way that practitioners approach diabetes care by educating them on emerging research and new technologies.
“These guidelines have also helped bring newer cardioprotective therapies into everyday practice, and they’ve pushed clinicians to personalize treatment rather than use a one-size-fits-all approach.”
Diabetes advocacy in the internet age
In 1996, the ADA launched their website, diabetes.org, to bring diabetes to the modern internet age and reach more people than ever before.
“Today the Standards of Care in Diabetes are available online and through an app. Providers can access a wealth of supporting materials, continued learning and patient resources online,” said Dr. Kalyani. “For people living with diabetes, information to support them at every stage in their diabetes journey can be found on diabetes.org.”
Since the website was launched, the ADA has continued to increase their presence across the nation.
In 1999, it launched the Safe at School® campaign to help create safer conditions for students at school living with diabetes; and in 2012, launched what is today known as Project Power, which focuses on diabetes education, physical activity and obesity prevention for youth at an increased risk of developing type 2 diabetes.
“Well-managed diabetes during the school day and at all school-sponsored events is crucial for a student’s ability to learn and to support normal growth and development. The American Diabetes Association launched its award-winning Safe at School campaign almost three decades ago,” said Dr. Kalyani. “Since its inception, Safe at School’s efforts have been successful in helping to ensure all children with diabetes receive needed diabetes care, are treated fairly, and have the same opportunities as their classmates.”
Diabetes management for children/students includes monitoring glucose levels, administering insulin and other medications, monitoring and calculating food intake and always having a school nurse or trained non-clinical school staff available.
“Safe at School has worked tirelessly to lead legislation in a number of states to enable trained non-clinical school staff to provide diabetes care, including the administration of insulin. Today, 35 states permit insulin administration in the school setting by someone other than a school nurse or licensed health care professional,” said Dr. Kalyani. “Passing and implementing state laws allowing the provision of diabetes care by trained lay school employees is critical to the health and safety of students with diabetes as more students are being diagnosed with diabetes.”
Moving forward in diabetes care
Managing diabetes effectively is in many ways connected to a patient’s nutrition habits and weight – being overweight or obese can cause increased risk for potential health complications.
For example, obesity is a risk factor for cardiovascular issues, according to the Centers for Disease Control and Prevention (CDC), and has been linked to insulin resistance. Cardiovascular disease is, in fact, the number one cause of death for patients with diabetes, according to the ADA.
As a result, the ADA has begun to focus its education and advocacy efforts around proper nutrition and reducing nationwide incidence of obesity.
Regular physical activity, maintaining a healthy weight, healthy eating for prediabetes and diabetes and taking care of mental well-being are all steps that patients can take outside of a clinical setting for proper management of diabetes and to avoid cardiovascular disease risk.
In 2024, the ADA formed the Obesity Association™, a division of the ADA, to help change the conversation on obesity and reduce its prevalence. The ADA now develops trusted, evidence-based Standards of Care in Overweight and Obesity to improve care for people living with overweight and obesity.
“The creation of the Obesity Association is a natural and necessary evolution for the ADA,” said Dr. Samar Hafida, vice president of the Obesity Association™. “This initiative is about building a larger tent, not moving to a new one. For the type 2 diabetes community, it means integrating obesity treatment as a central strategy for prevention and remission. For the type 1 diabetes community, it means acknowledging that obesity can co-occur, creating complex management challenges and ensuring we have specialized resources to provide holistic care.”
The affordability of insulin is an incredibly important part of advocating for patients with diabetes, as patients cannot live without it – insulin is a key hormone for regulating blood sugar levels.
Many types of insulin are used to treat diabetes, according to the CDC. Patients with type 1 diabetes usually take insulin, or in some cases a combination of insulins, and some people with type 2 diabetes may also need to take insulin.
The best insulin or combination of insulins for a patient depends on how active they are, the food they eat, how well they can manage their blood sugar levels, their age and how long it takes their body to absorb insulin, which is different for each person.
Approximately half of all states and the District of Columbia have now enacted legislation that caps co-payments on monthly insulin and some also limit cost sharing for supplies, according to the ADA.
“The American Diabetes Association has been the leading voice advocating for insulin affordability for a decade,” said Dr. Kalyani. “Ensuring that all people with diabetes have access to the care they need is a priority for the ADA.”
In 2023, after years of the ADA advocating for affordable insulin for patients and their families, Medicare put an out-of-pocket cost cap on insulin of $35 monthly.
“While we have been able to help achieve significant progress on the issue of insulin affordability and encouraging patient assistance programs from insulin manufacturers that make the life-saving medication more affordable, we know that our work is not done,” said Dr. Kalyani. “Today, the ADA’s advocacy team is working to cap cost-sharing for insulin in commercial insurance plans and to increase mechanisms to make insulin affordable for those living without insurance.”
By pursuing advocacy efforts such as more affordable insulin, the ADA continues to build on its decades of success and explore new approaches to advance the future of diabetes care.
“From the earliest fellowships in the 1950s to the innovations shaping care today, ADA has fueled progress across every era of diabetes research while training generations of leaders,” said Dr. Kalyani.
“Ultimately, initiatives such as the Obesity Association are an expansion of our arsenal,” said Dr. Hafida. “We are strengthening our fight against the diabetes epidemic by directly addressing its most significant predictor, all while redoubling our efforts to support every individual living with every form of this disease.”