American Diabetes Month Spotlight: MCPHS Professor Contributes to ADA Guideline Updates

Professor Alissa Segal, a leader in pharmacy practice, helps set new global standards in diabetes treatment.

Many Massachusetts College of Pharmacy and Health Sciences (MCPHS) students will spend a significant amount of their careers treating patients with diabetes. After all, the disease affects one of every 10 Americans.

They may not realize that the guidelines they will likely use for treating the disease, the American Diabetes Association (ADA) Standards of Care in Diabetes, have a distinctive contribution from MCPHS.

Professor of Pharmacy Practice Alissa Segal, PharmD, RPh, CDCES, CDTC, FCCP, is working with some 20 colleagues on the ADA’s Professional Practice Committee to update the guidelines for 2025, incorporating guidance based upon the latest scientific research and clinical trials.

She also participated in the 2024 guidelines, which included among its dozens of recommendations additional guidance on using new obesity medications, recommendations for the pharmacologic treatment of Type 1 diabetes, and treatments for metabolic dysfunction-associated steatotic liver disease.

“It's probably the most consistently used guideline (for diabetes care),” Segal said, “and a lot of countries use it beyond the US,” she said, speaking just days before the start of National Diabetes Month in November.

Experts, including clinicians, researchers, health care insurers, and policymakers, routinely use and consult the Standards of Care.

Updating a Classic

At 17 chapters and about 300 pages, the guide’s weighty authority is widely recognized. It is updated annually, with the 2025 edition set to be released in December. However, Segal must keep the latest findings confidential until then.

She finds working on the guidelines stimulating and collaborative. “Committee members are assigned to contribute to the writing of certain sections based on their experience and background, but we all contribute to all of them,” Segal said. “We all review, provide peer review, as well as review the proofs of the full update.”

As the only pharmacist on the committee, her insights on medications weave throughout the Standards. “I feel like I've touched a good number of sections,” Segal said.

A Fertile Time for Diabetes Research

Technology is accelerating rapidly in the treatment of both Type 1 and Type 2 diabetes. For example, Segal said some of the most common artificial intelligence integrated devices use predictive algorithms to adjust insulin delivery in real-time by analyzing an individual’s glucose data and patterns, and other AI devices aid in the detection of serious complications, such as retinopathy.

Another promising trend is that some new medications are demonstrating efficacy in patients with multiple issues. GLP-1 agonists like Trulicity and Ozempic have shown positive results, lowering glucose levels and decreasing the risk of subsequent cardiovascular events. Having such dual capabilities could ultimately lead to lower costs and better outcomes for patients, Segal said.

“We are focusing more on how we can hit two birds (multiple disease targets or problems) with one stone,” she said.

At the School of Pharmacy, Boston, Segal is the Director of the Doctor of Pharmacy Honors Program, mentoring the next generation of pharmacists. One of her favorite rewards is “seeing the light bulb go on for a fellow or student. They are like, oh, that’s why we do this.”

Almost all of her research focuses on improving the care of individuals with diabetes. “Whether that is assessing a different way of thinking about the treatment, or providing the education within a treatment protocol, or assisting with even the compounding of the product, all of it is aimed to better understand: does that treatment work? Would this change the way we're thinking about the care of these individuals?”

Although her two-year term on the ADA committee is ending, Segal said she may be invited to serve another year to update the next volume. “I have loved doing it, knowing my work helps not just the students or patients that I work with but so many others as well. Hopefully, I will have the opportunity to continue for another year.”