According to a recent report from AARP Bulletin, America is facing a full-scale war on diabetes and nurses are on the front lines.

Diabetes now affects 32 million midlife and older adults in the United States. Another 65 million have prediabetes, according to the Centers for Disease Control and Prevention.

In 2025, the CDC and the American Diabetes Association called diabetes “one of the most serious health problems our country has ever faced.” Yet science has delivered more tools than ever to prevent, manage and even reverse the disease.

“Diabetes is on the ropes,” says Dr. John Buse, professor of medicine at the University of North Carolina at Chapel Hill. “It’s just a matter of executing what we know.”

For nurses, that execution happens daily through screening, education, advocacy and patient support. Here is what the latest science shows and how nurses can help turn the tide.

Diabetes affects more than 32 million U.S. adults and nearly 80 percent of older adults with prediabetes do not know they are at risk. Nurses can reduce complications by promoting regular screening, lifestyle interventions, medication adherence, and use of new technologies like continuous glucose monitors and smart insulin delivery systems.

The Scope of the Crisis

Diabetes is a major driver of heart disease, stroke, blindness, kidney failure, nerve damage and amputations. Untreated diabetes shortens life expectancy by an average of six years. It is now the seventh-leading cause of death in the U.S., responsible for more than 95,000 deaths in 2023.

The financial burden is staggering. The American Diabetes Association reports diabetes cost the U.S. healthcare system $307 billion in 2022, surpassing cancer and heart disease.

Despite this, the disease often goes undetected:

• About 20 percent of adults age 45 and older with diabetes do not know they have it.
• Nearly 8 in 10 older adults with prediabetes are unaware of their risk.
• Nearly half of U.S. adults have not had recent blood sugar screening.

“Everyone should know their blood sugar number, the way you know your blood pressure or cholesterol,” says Dr. Samuel Dagogo-Jack, endocrinologist at the University of Tennessee Health Science Center.

Nursing takeaway: Encourage routine screening, especially for adults age 35 and older. Reinforce ADA guidelines for testing every three years or annually for patients with prediabetes.

Why Prevention Still Falls Short

A 2025 study published in JAMA found fewer than half of Americans with diabetes have it under control. That dramatically increases the risk for life-threatening complications.

“We’re taking better care of diabetes and doing a much better job of handling the complications,” says Dr. Silvio Inzucchi, director of the Yale Medicine Diabetes Center. “But there’s just more diabetes out there. We haven’t gone as far as we could with prevention.”

Nursing takeaway: Prevention counseling should be ongoing, not a one-time conversation. Assess food access, stress, mental health, mobility and social determinants that affect patient adherence.

Five Breakthroughs Changing Diabetes Care

1. GLP-1 Medications and Obesity Treatment

Drugs like Ozempic, Wegovy, Mounjaro and Zepbound help regulate blood sugar, reduce appetite and promote weight loss. Among adults with diabetes:

• 1 in 3 people ages 50 to 64 used a GLP-1 in 2024
• 1 in 5 adults age 65+ used one

One study found tirzepatide reduced progression from prediabetes to diabetes by 94 percent.

Gaylene Cornell, 68, lost 93 pounds after starting Ozempic. “My brain tells me I’m full and I’m done eating,” she says.

However, cost and side effects remain barriers. New federal pricing plans announced in November aim to cap monthly costs and expand Medicare coverage.

Nursing takeaway: Monitor side effects, reinforce protein intake to protect muscle mass, and screen for fall risk in older adults. Educate patients about realistic expectations and long-term lifestyle changes.

2. Diabetes Prevention Programs That Work

The National Diabetes Prevention Program (NDPP) has helped nearly one million Americans. It reduces diabetes risk:

• 58 percent overall
• 71 percent in older adults

Elpidio Gutierrez, 68, joined an NDPP class and lowered his A1C from 5.7 to 5.5. “I’m not looking for perfection, just moderation,” he says.

Medicare has covered NDPP since 2018.

Nursing takeaway: Actively refer patients with prediabetes. Do not wait for providers to initiate. Explain the social support benefits and long-term cost savings.

3. Continuous Glucose Monitors

CGMs provide real-time glucose data and improve self-management. In a 2021 study, adults using CGMs lowered A1C by 1.1 percentage points.

“CGMs are a game changer,” says Ashley Pickering Brown of Joslin Diabetes Center.

Medicare expanded coverage in 2023. In 2024, the FDA approved over-the-counter CGMs.

Nursing takeaway: Teach patients how to interpret CGM data. Connect trends to food, sleep, stress and physical activity.

4. Heart and Kidney Protection

SGLT2 inhibitors and GLP-1s are now ADA standards of care for patients with diabetes and cardiovascular disease. These medications:

• Reduce heart attack and stroke risk by 9 to 20 percent
• Lower kidney disease risk by 15 percent

“These drugs have a significant impact on multiple facets of health,” says Dr. Eden Miller, diabetes specialist in Oregon.

Nursing takeaway: Reinforce medication adherence. Monitor blood pressure, renal labs and cardiovascular symptoms. Advocate for guideline-based prescribing.

5. Smart Insulin Delivery Systems

Automated insulin systems use CGM data to deliver insulin in real time. Studies published in The New England Journal of Medicine in 2025 show improved glucose control.

Dr. Miller uses Omnipod 5. “It’s my little diabetes buddy,” she says.

Nursing takeaway: Provide device education. Normalize insulin use in type 2 diabetes. Address stigma and fears.

Evidence-Based Ways to Lower Diabetes Risk

According to AARP Bulletin’s reporting, research shows:

• Skip sugary drinks: Each daily 12-ounce drink increases diabetes risk by 25 percent.
• Cut ultra-processed foods: Replacing 10 percent of calories lowers risk 17 percent.
• Walk 2,000 steps daily: Lowers risk 12 percent.
• Strength train weekly: Lowers risk 17 percent.
• Improve sleep habits: Poor sleep increases risk up to 45 percent.
• Lose 5 percent body weight: Reduces progression to diabetes by 72 percent.

“Diabetes is not inevitable,” says Dagogo-Jack. “There is plenty you can do to lower your risks.”

The Nurse’s Role in the War on Diabetes

Nurses are uniquely positioned to:

• Promote routine screening
• Refer to prevention programs
• Teach CGM use
• Address medication barriers
• Provide culturally competent education
• Support behavior change with empathy

“We have all the tech, all the new drugs, all the ways to prevent or minimize risks,” says Dr. Betul Hatipoglu of University Hospitals. “But people need to remember they are not alone.”

That message matters.

Because winning the war on diabetes is not just about science. It is about access, education, trust and human connection. And no one delivers that better than nurses.

This article is adapted from reporting originally published by AARP Bulletin.