The American Diabetes Association and the European Association for the Study of Diabetes have issued revised consensus reports on treating type 1 and type 2 diabetes in adults, published in the journals Diabetologia and Diabetes Care. According to AD HOC NEWS, the type 2 update moves the two organizations away from a glucose-first approach and toward care that treats coexisting conditions and protects organs from the outset. The recommendations were drafted by a 16-member panel chaired jointly by Melanie Davies for the EASD and John Buse for the ADA, with early details presented at the 62nd EASD Congress held in Milan from 28 September to 2 October 2026.
Why it matters
The type 2 consensus has existed in some form since 2006 and was last revised in 2022. Its new direction matters because it changes when patients may be offered newer drug classes, not just which ones. AD HOC NEWS reports that SGLT2 inhibitors and GLP-1-based therapies, including dual GIP/GLP-1 receptor agonists, should now be started earlier — potentially as soon as a diagnosis is made. The stated aim is to shield organs before damage sets in, rather than waiting for blood sugar to drift out of range.
That shift also reframes what counts as successful treatment. The guidance places healthy living, psychological support and structured weight management at the base of every care plan, alongside medication. It lists a balanced diet, no tobacco use and adequate rest as core components.
A 24-hour framework for daily movement
One of the newly added elements is a structured 24-hour movement framework built around five activities the panel calls the "5 S": standing, stepping through the day, sweating through vigorous activity, strengthening through targeted resistance training, and sleep. AD HOC NEWS reports that the framework is meant to show how activity and rest across a full day influence metabolic processes, rather than treating exercise as a single isolated block of time.
For patients who already have cardiovascular disease, chronic kidney disease or heart failure, the two organizations advise considering early combination treatment with an SGLT2 inhibitor plus a GLP-1 therapy. The type 2 report is based on a systematic review of scientific literature published since 2022.
Type 1 guidance puts technology first
The companion report on type 1 diabetes in adults, which replaces a 2021 version, gives priority to technology. According to AD HOC NEWS, it identifies automated insulin delivery (AID) systems, used continuously, as the best method for administering insulin.
The document also addresses newer drug options. It names teplizumab as the first disease-modifying therapy approved by the US Food and Drug Administration, a treatment that can delay the onset of clinically manifest stage 3 type 1 diabetes. For obesity in people with type 1 diabetes, the report sets out a range of options: behavioral therapy, second-generation GLP-1-based medicines and, where appropriate, bariatric surgery.
Both reports appear in Diabetologia and Diabetes Care. What to watch next is how quickly the earlier use of SGLT2 inhibitors and GLP-1 therapies is taken up in routine practice, and whether prescribing patterns in primary care follow the panel's lead.
