An ADA–EASD panel has updated its 2022 consensus on managing type 2 diabetes in non-pregnant adults, reviewing the evidence published since. It is a consensus report synthesising trials and guidelines, not a new trial in itself.
The focus moves from lowering glucose to the holistic management of type 2 diabetes and the long-term conditions that come with it. The central change for prescribers: SGLT2 inhibitors and GLP-1-based therapies should be used earlier, potentially from diagnosis, for organ protection rather than held back until glucose targets are missed. Earlier combination of the two is advised where cardiovascular disease, chronic kidney disease or heart failure coexist.
In Indian practice generic SGLT2 inhibitors are cheap and widely stocked, which makes the from-diagnosis position realistic; GLP-1 therapies remain costly, so equitable access is the constraint the report itself names.
- Consider an SGLT2 inhibitor or a GLP-1-based therapy at diagnosis for organ protection, not only after glucose targets are missed.
- In type 2 diabetes with established cardiovascular disease, chronic kidney disease or heart failure, consider an SGLT2 inhibitor and a GLP-1 therapy together.
- Treat eating, physical activity, sleep, tobacco and alcohol, weight and psychological support as core parts of the plan, not add-ons.
- Agent choice now follows cardiorenal protection and weight, with glucose lowering one aim among several.
- Where GLP-1 cost limits access, a generic SGLT2 inhibitor delivers much of the cardiorenal benefit at low cost.
Why it matters
It moves SGLT2 inhibitors and GLP-1 agents from rescue therapy to first choices, changing what you reach for at diagnosis.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for diabetes & endocrinology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free