What are the key updates in the HHS (Health and Human Services) terminology for ADA (American Diabetes Association) 2025?

Key HHS Terminology Updates in ADA 2025 Standards

The ADA 2025 Standards introduced several critical terminology shifts, most notably replacing "Chronic Care Model" with "evidence-based care models," expanding "diabetes health care maintenance" to "diabetes management, risk factors, and complications," and changing "people with diabetes and care partners" to "people with or at risk for diabetes and caregivers." 1

Major Terminology Changes from 2024 to 2025

Care Model Framework

• The 2024 guidelines specifically referenced the "Chronic Care Model" as the framework for diabetes management 1
• The 2025 guidelines now use the broader term "evidence-based care models" rather than naming a specific model, allowing for more flexibility in care delivery approaches 1
• This shift reflects recognition that multiple validated care models exist beyond the traditional Chronic Care Model 1

Population Scope Expansion

• 2024 terminology focused on "people with diabetes" in collaborative decision-making 1
• 2025 expanded to "people with or at risk for diabetes and caregivers" to explicitly include prevention populations and recognize the role of caregivers 1
• This change emphasizes upstream prevention and acknowledges the critical support role of caregivers in diabetes management 1

Assessment Terminology Evolution

• 2024 used "diabetes health care maintenance" as the assessment framework 1
• 2025 shifted to "diabetes management, risk factors, and complications" as a more comprehensive assessment terminology 1
• This reflects a more holistic approach that encompasses active management, risk stratification, and complication monitoring rather than just maintenance 1

New Structural Additions in 2025

Quality Improvement Mandate

• 2025 added an entirely new recommendation (#5) requiring health systems to "adopt a culture of quality improvement, implement benchmarking programs, and engage interprofessional teams" 1
• This recommendation carries Grade A evidence, indicating strong support for systematic quality improvement processes 1
• The 2024 guidelines had only 4 recommendations in this section, making this a substantive structural change 1

Enhanced Care Planning Language

• 2025 introduced "proactive care planning" as explicit terminology in care system requirements 1
• This replaces the more passive 2024 language and emphasizes anticipatory rather than reactive care 1

Clinical Implications

These terminology changes are not merely semantic—they represent fundamental shifts in how diabetes care should be conceptualized and delivered:

• The move away from a single named model (Chronic Care Model) to "evidence-based care models" allows healthcare systems to adopt frameworks that best fit their populations while maintaining evidence-based standards 1
• Including "at risk" populations in the primary terminology signals that diabetes care begins before diagnosis, emphasizing prevention as core to diabetes management 1
• The shift from "maintenance" to "management, risk factors, and complications" reframes diabetes care as active disease management rather than passive monitoring 1

Common Pitfalls to Avoid

• Do not continue using "Chronic Care Model" as the exclusive framework when discussing diabetes care systems—the 2025 standards deliberately broadened this 1
• Do not limit collaborative decision-making discussions to diagnosed patients only—explicitly include at-risk populations and caregivers per 2025 terminology 1
• Avoid framing diabetes assessments as merely "maintenance"—use the comprehensive "management, risk factors, and complications" framework 1