Type 2 diabetes care is about more than bringing down a blood sugar number. A new joint report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) puts protecting the heart and kidneys, supporting weight management and improving everyday wellbeing at the centre of care.
Published on 2 October 2026, the 2026 ADA/EASD consensus report updates the organisations’ previous 2022 report. It concerns adults with type 2 diabetes who are not pregnant. Its main message is encouraging: a care plan can look beyond glucose readings and address the wider health needs of the person living with diabetes.
That does not mean everyone should start a new medicine. The recommendations need to be matched to individual health conditions, potential side effects, preferences, affordability and local prescribing rules.
What has changed in the 2026 report?
The report brings together research and expert recommendations rather than presenting the results of one new clinical trial. It gives greater attention to early, integrated care: considering the risk of complications alongside blood glucose, rather than waiting for every other part of health to become a separate problem.
The ADA’s announcement highlights earlier consideration of medicines with heart and kidney benefits, a broader approach to conditions that coexist with diabetes, and a full-day framework for healthy behaviours.
For patients, the useful change is the conversation this can support. A review might ask not only whether glucose is within the agreed range, but also what is being done for heart health, kidney health, weight, sleep and emotional wellbeing.
Blood sugar still matters, but it is not the whole picture
HbA1c remains an important part of diabetes care. It reflects average blood glucose over roughly three months, as explained in the NIDDK guide to the A1C test. However, it is not a complete report on someone’s heart or kidney health.
The consensus recommends matching treatment to the person’s overall clinical profile. Existing cardiovascular disease, heart failure or chronic kidney disease may affect which medicines are considered, even when blood glucose is already close to an agreed target.
For someone reading their results at home, the distinction is important. An encouraging HbA1c result does not make other aspects of care irrelevant. Equally, a result above target should prompt a supportive discussion about treatment and barriers, not blame.
Why are SGLT2 inhibitors and GLP-1-based treatments discussed?
These are groups of medicines used in diabetes care. Some individual medicines have demonstrated benefits beyond lowering blood glucose, including cardiovascular or kidney outcomes in particular populations.
The report supports considering appropriate organ-protective treatment earlier, potentially from diagnosis. It also discusses combining SGLT2 inhibitors and GLP-1-based therapy in selected people with relevant cardiovascular or kidney disease. This is a clinical decision, not a standard combination for every person with type 2 diabetes.
Evidence and approved uses differ between medicines and countries. Someone with established disease may have a different expected benefit from someone whose baseline risk is low. The report explicitly notes that absolute benefits can be more modest in lower-risk populations.
Metformin has not suddenly become unsuitable. Medicine choice still depends on the full situation, and the new report is not a reason to stop metformin, insulin or another prescribed treatment without a clinical review.
A whole-day approach to food, movement and sleep
Healthy behaviours remain foundational, including when medicines are prescribed. The report uses five themes to bring movement and rest into the same conversation: standing, stepping, sweating, strengthening and sleep.
This framework is broader than simply asking whether someone goes to the gym. It includes time spent sitting, everyday movement, planned activity, muscle strength and sleep. Activity needs to be adapted to preferences, functional ability and health conditions; complications, insulin use or previous low glucose episodes may require additional assessment.
The nutrition message is similarly individual. There is no single eating pattern or fixed balance of carbohydrate, protein and fat that suits everyone with type 2 diabetes. The report recommends personalised nutrition support, with attention to food quality, culture, feasibility and sustainable habits.
During significant weight loss, protecting nutrition and muscle strength also matters. The report calls for guidance on adequate protein intake and resistance exercise where appropriate. This is not an instruction to follow a high-protein diet regardless of kidney health.
Support belongs in the treatment plan
The report treats diabetes self-management education and support as a core part of care, not an optional extra. It recommends revisiting support over time, including when treatment changes, complications develop or someone moves between care settings.
It also calls attention to mental health, diabetes distress and practical barriers. Cost, access to suitable food, housing stability and access to care can affect what is achievable. A useful plan takes these realities seriously instead of assuming that more instructions will solve every difficulty.
Broader care also includes attention to conditions such as heart failure, fatty liver disease, obstructive sleep apnoea and oral health. This does not mean everybody needs every possible test: assessment and follow-up should reflect clinical needs.
Our guide to diabetes educators and self-management support explains what that help can look like. For a separate technology-focused discussion, see diabetes technology in primary care.
Benefits need to be balanced with safety
Organ-protective medicines are not risk-free. The report describes genital infections and the uncommon but serious risk of diabetic ketoacidosis with SGLT2 inhibitors, including when glucose is not very high. GLP-1-based treatments commonly cause digestive side effects such as nausea, vomiting, diarrhoea or constipation, and individual warnings and contraindications still matter.
A prescribing discussion should therefore include expected benefits, side effects, relevant monitoring and an agreed plan for illness or procedures. Do not use this article to change doses, pause treatment or add a medicine. Those decisions require advice based on the actual medicine and clinical circumstances.
Questions worth taking to a diabetes review
- Does my care plan address heart and kidney health as well as glucose?
- Which treatment options are relevant to my conditions, and what are their benefits and risks?
- Are sleep, emotional wellbeing, nutrition or strength concerns affecting my care?
- What education or practical support is available if the current plan is difficult to follow?
- Which screening checks and follow-up appointments are appropriate for me?
What this report can and cannot tell us
This is evidence-informed consensus guidance, not proof that one identical care package produces the same outcome for everyone. The literature search covered research published since 2022, with additional references considered by the writing group. The authors acknowledge evidence gaps and differences between patient groups.
The report was developed primarily for healthcare teams in the United States and Europe. Availability, costs and prescribing approvals elsewhere need local consideration. It is also distinct from the ADA’s annually published Standards of Care.
Common questions
Does everyone with type 2 diabetes need a new medicine?
No. The report supports individualised decisions. Existing conditions, risk, tolerance, access and preferences all matter.
Does it apply to type 1 diabetes or pregnancy?
Not directly. Its stated population is non-pregnant adults with type 2 diabetes; other situations require their own guidance.
What is the main takeaway?
Good diabetes care should help protect long-term health and support daily life, not focus on glucose alone. The encouraging development is a more joined-up approach, with the person living with diabetes at the centre.
Sources
- Davies MJ, Aroda VR, Bajaj M and colleagues. Management of type 2 diabetes, 2026: ADA/EASD consensus report. Diabetologia, 2 October 2026. DOI: 10.1007/s00125-026-06855-7. Also published in Diabetes Care, DOI: 10.2337/dci26-0141.
- American Diabetes Association. Joint consensus report announcement, 2 October 2026.
- National Institute of Diabetes and Digestive and Kidney Diseases. The A1C Test & Diabetes.
This article provides general health information, not individual medical advice.