The American Diabetes Association’s 2025 Standards of Care emphasize individualized glycemic targets, recognizing that one-size-fits-all A1C goals don’t work for everyone. They highlight CGM metrics like Time in Range (TIR) and stress preventing hypoglycemia while personalizing treatment. 👏
📄 BUT here’s the issue—while the guidelines focus heavily on glucose levels, there’s little discussion on the real root cause: hyperinsulinemia & insulin resistance. 🤔
🔬 Why it matters:
Many people with T2D and even some with normal glucose have chronically high insulin levels long before A1C spikes.
Focusing only on glucose control without addressing insulin resistance may lead to over-reliance on glucose-lowering drugs rather than lifestyle interventions that improve metabolic health at the root.
Insulin levels aren’t even part of routine screening, despite their crucial role in metabolic dysfunction.
🎯 Takeaway: Glycemic control is important, but we need a paradigm shift that looks beyond just blood sugar. It’s time to focus on insulin resistance, lifestyle interventions, and metabolic health as a whole!
💬 What do you think? Should insulin testing be a bigger part of diabetes care?
American Diabetes Association Professional Practice Committee. (2025). Glycemic goals and hypoglycemia: Standards of care in diabetes—2025. Diabetes Care, 48(Suppl. 1), S128–S145. https://doi.org/10.2337/dc25-S006
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