Reframing Diabetes Guidelines to Address Real-World Barriers, with Athena Philis-Tsimikas, MD

Despite decades of progress in diabetes care, stark disparities remain in outcomes among patients, especially when it comes to complications linked to poor disease management. While clinical guidelines outline what to prescribe, they rarely address how to ensure equitable access or implementation. Social determinants of health, cultural context, and systemic barriers all play major roles in whether patients can benefit from evidence-based care. As outcomes for diabetes-related complications begin trending in the wrong direction after years of decline, it’s increasingly clear that tackling these external factors is essential.

Athena Philis-Tsimikas, MD, corporate vice president of Scripps Whittier Diabetes Institute at Scripps Health in San Diego, California, gave a talk exploring the impact of social determinants of health at the 2025 American Diabetes Association (ADA) Scientific Sessions, held June 20-23, in Chicago, Illinois.

HCPLive spoke with Philis-Tsimikas to learn more about how these non-medical factors can affect the health of people with diabetes. She also shared some ways that clinicians can engage with their patients’ social determinants of health that may be affecting their outcomes, and some strategies that her center employs to help address these factors. She emphasized the need for clinical guidelines on treating diabetes to consider non-medical factors of health and how to navigate them in their recommendations.

“The clinical guidelines give us great information on which drugs to use, which technology to use, but they don't necessarily tell us how to overcome some of these other barriers that exist,” Philis-Tsimikas said.

“Social determinants of health, as well as other determinants, the digital divide, cultural adaptations, all these other things that are important as well. So being able to offer a systematic approach on how to overcome this within the guidelines, I think, is important, in addition to all the other terrific information that is in the current guidelines.”

Philis-Tsimikas's disclosures include Dexcom, Lilly, Medtronic, Sanofi, and Novo Nordisk.

REFERENCE

Philis-Tsimikas A. Nonmedical Factors That Influence Diabetes-Related Complications. Presented at: 2025 ADA SciSessions; June 20-23; Chicago, Illinois.