- Design
- Joint consensus report with systematic examination of literature since 2022
- Population
- Non-pregnant adults with type 2 diabetes
- Primary outcome
- Recommendations for holistic management of type 2 diabetes and associated long-term conditions
- Effect
- No pooled effect estimate; advocates earlier SGLT2 inhibitor and/or GLP-1-based therapy
The American Diabetes Association and the European Association for the Study of Diabetes have updated their joint consensus report on managing type 2 diabetes in non-pregnant adults. It was last revised in 2022 and draws on a systematic examination of publications since then.
The framing has widened from managing hyperglycaemia to managing type 2 diabetes together with its risk of multiple long-term conditions. Lifestyle behaviours (eating, 24-hour physical behaviours including sleep, avoiding tobacco and substances), psychological support and weight management are described as fundamental.
The report advocates earlier use of SGLT2 inhibitors and/or GLP-1-based therapies, potentially from diagnosis, for organ protection and better long-term outcomes. It suggests considering earlier combination of the two classes in people who also have cardiovascular disease, chronic kidney disease or heart failure.
In practice this shifts the question at diagnosis from how fast to lower HbA1c towards which organ risks this person carries. In India, where cost often decides the choice, the practical issue is access: this is a US and European consensus, and local guidance and affordability still shape what can be prescribed.
- At diagnosis, record cardiovascular disease, kidney function, albuminuria and heart failure alongside HbA1c, because these drive drug choice.
- Consider an SGLT2 inhibitor and/or a GLP-1-based therapy early where organ protection is relevant, rather than waiting for metformin to fail.
- Where cardiovascular disease, CKD and heart failure coexist, discuss early combination of both classes.
- Pair drug choice with weight management, sleep, activity and psychological support.
- Check local availability and cost before promising a regimen; the report is aimed at US and European care teams.
Why it matters
It challenges the habit of treating glucose first and organ risk later.
Don't overread it
A consensus report advocates earlier use; it does not make every newly diagnosed person a candidate for combination therapy.
The statistics, in plain English
This is a consensus report, not a trial. It carries no single effect size; its recommendations rest on the trials the panel reviewed, and the strength differs from one recommendation to the next. Consensus statements reflect expert judgement and can move ahead of the evidence in some subgroups.
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