Q&A: Pharmacists Can Address ADA Standards Across All Settings

With 565 individual recommendations embedded in the 2026 American Diabetes Association (ADA) Standards of Care, no single provider can realistically address them all. That reality is quietly opening one of the most significant opportunities the pharmacy profession has seen in diabetes management.

From medication optimization and diabetes self-management education to point-of-care A_1c testing, test-and-treat services, and more, pharmacists are already stepping into roles across the expansive standards—often in communities where access to traditional diabetes care is limited or inconsistent.

Read through expert insights from Sandra Leal, PharmD, MPH, diabetes specialist and vice president of pharmacy professional relations at CVS Health, on the pharmacist’s role in addressing ADA standards and how incorporating them into diabetes care teams is essential.

READ MORE: Embedded Pharmacists Are Vital Yet Underutilized in Diabetes Care

Drug Topics: Which specific elements of the ADA standards of care do you see as the highest-yield opportunities for pharmacists to act on, particularly in community or ambulatory care settings?

Sandra Leal: First, I just want to really thank the ADA for them including pharmacists as really active members of their communities. I’ve been sitting on a group with ADA that’s really incorporated a lot of different providers on that team, including the pharmacist. I appreciate that they’re acknowledging the pharmacist to be able to do work that helps patients with diabetes have better control. Looking at the standards, I was at the American Pharmacists Association (APhA) recently, co-presenting with the ADA, and we were talking about the standards of care and the role that pharmacists can play on the teams that help to address the standards.

There are—this was a statistic that was amazing to me—about 565 recommendations in the current 2026 ADA Standards of Care. As you can imagine, there are a lot of opportunities for pharmacists to really help address any of these standards because no single one provider can address all of these for an individual patient. You can think of the natural things that pharmacists would gravitate to [like] medication optimization. There’s a lot of work around that. But there are a lot of other areas of the standards of care, depending on your setting, where you can really make a big difference. Some of it is in diabetes self-management education and support. There are pharmacists that are currently doing classes in accredited programs, they’re doing education around that, but there’s also other areas around the standards where pharmacists can really intervene.

But again, I think we naturally think of pharmacists as the medication experts and that’s the focus. In reality, pharmacists are really addressing standards of care across the board, again, depending on their area of practice. There’s just so much opportunity there. I just think about my previous practice. We were doing everything from screening patients, identifying opportunities to close gaps, referring to other providers to make sure we were meeting those standards. In just the general management, it’s really being accessible for patients who need care and being an advocate during this journey that the patient is on. There’s just a ton of opportunities that pharmacists [can] really come in and really step in to be able to help people have better outcomes.

Drug Topics: From a pharmacy perspective, what strategies or tools have shown the most promise for delivering consistent, high-quality diabetes care to underserved populations?

Sandra Leal: I think a couple of things that really stand out in my mind is just consistency and access. I think when you look at the footprint of pharmacies across the US, we are very accessible, and I don’t want to repeat the statistic. Everybody knows the locations of pharmacies relative to the population. There are a lot of pharmacies out there. You always have availability to an accessible provider during the times that pharmacies are open, and the good thing about that is they’re open late hours, on weekends. That’s an amazing process. But really looking at where these pharmacies are located, looking at underserved neighborhoods, looking at some of the frequency of how many more times an individual visits a pharmacy versus the ability for them to see their provider—that’s key.

Now, from a pharmacist perspective, there are so many new services that are being offered in a pharmacy. If you think about just a shift in vaccinations and where they’re occurring, they’re occurring more in community pharmacies now than in some of the traditional places we used to get them, like in our physician office. We’re looking at other areas where we’re seeing that type of access starting to grow more and more in pharmacies. That includes test-and-treat. There are places that are now offering education, A_1c as point of care, tools, and technology that are allowing pharmacists to be able to be an accessible point for a person that might be more accessible than their usual care places.

I think the big thing for pharmacists is really to maintain that communication with the rest of the care team, be able to communicate and partner, being able to fill those 565 recommendations that are being asked for by the ADA Standards of Care. I can’t stress that enough, because there are so many. I’m going to give a personal example. My daughter developed type 1 diabetes when she was 16. I was already managing people with diabetes, so it’s sort of ironic that this happened. But I just think about how many times we go to the pharmacy for services, help, or really for anything, like the vaccines I think about is just one of the more common things that we do. If it weren’t for the pharmacist, it would just make our lives a lot more difficult to try to get those types of services when we are able to access them.

[It’s the] same thing for supplies, medications, questions that we might have. I think pharmacists really are consistently there and they’re accessible, and they really provide services that are very helpful. Ideally, if we could look at that more and just really align some of the sustainability models, we could do more of this. I think we’re trying to get there with the tools and the capacity we have now, but as we’re seeing more expanded care, if we’re seeing more increased scope, you could just see the opportunities. I think the patient ultimately benefits, because that’s what I think of every day as I’m trying to do the work I’m trying to do. How do we make lives easier for the patients that have conditions like diabetes?

READ MORE: Diabetes Resource Center