New ADA/EASD consensus calls for earlier, more holistic management of type 2 diabetes

Updated guidance presented at EASD 2026 emphasizes earlier use of organ-protective therapies, individualized weight management, and a broader approach to preventing diabetes-related complications.

A new joint consensus report from the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) calls for a more proactive, integrated approach to managing type 2 diabetes, shifting the focus beyond glucose control to improving long-term cardiometabolic health. The updated statement, launched at the EASD Annual Meeting in Milan and simultaneously published in Diabetologia and Diabetes Care on October 2, 2026, builds on the previous 2022 consensus. It incorporates new evidence on treatments that can improve glycemic outcomes while also addressing weight management, cardiovascular and kidney risk, and other associated conditions.¹

A key recommendation is the earlier introduction of sodium–glucose cotransporter 2 (SGLT2) inhibitors and/or glucagon-like peptide-1 (GLP-1)-based therapies, potentially from diagnosis, for most people with type 2 diabetes. These treatments offer benefits beyond glucose lowering, including organ protection and improved long-term outcomes. Earlier combination treatment with both drug classes should also be considered in individuals with established cardiovascular or kidney disease, or high cardiovascular risk.¹

Rather than relying solely on a stepwise approach to treatment escalation, the consensus encourages clinicians to consider an individual’s broader risk profile from the outset. However, treatment should remain personalized, with a more gradual approach potentially appropriate for people at lower risk. Metformin also continues to have an important role in glucose management.

Weight management is another central theme, with recommendations for individualized weight-loss goals and greater consideration of weight-lowering medications and metabolic surgery where appropriate. The report also emphasizes the importance of nutrition, psychological support, and healthy behaviors throughout the day, including physical activity, resistance exercise, and sleep. The guidance broadens attention to conditions commonly associated with type 2 diabetes, including metabolic dysfunction-associated steatotic liver disease, obstructive sleep apnea, mental health conditions, and cardiovascular and kidney complications.

Developed by an international expert panel co-chaired by Prof. Melanie Davies and Prof. John Buse, the consensus highlights the importance of person-centered care that considers individual treatment goals, coexisting conditions, access to therapies, and social determinants of health. Overall, the 2026 update signals a move toward earlier intervention and more comprehensive management, with the aim of reducing complications and improving long-term outcomes for people living with type 2 diabetes.

Reference

1. Davies MJ, Aroda VR, Bajaj M, et al. Management of type 2 diabetes, 2026. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. Published online October 2, 2026. https://doi.org/10.1007/s00125-026-06855-7.