The American Diabetes Association and the European Association for the Study of Diabetes have published their first update since 2022 of their joint consensus on managing type 2 diabetes, and it advocates using GLP-1-based drugs or SGLT2 inhibitors earlier, potentially from diagnosis, to protect the heart and kidneys. The report appeared in Diabetologia on 2 October. It is the clearest signal yet from the two main professional bodies on either side of the Atlantic that these drugs can belong at the start of treatment rather than being held back until other medicines fail.
What the abstract says
The consensus is written for the multidisciplinary teams that treat non-pregnant adults with type 2 diabetes in the US and Europe, and was informed by a systematic examination of studies published since 2022. According to its abstract, it makes four shifts.
First, the focus broadens from controlling blood sugar to managing type 2 diabetes as a whole, along with the other long-term conditions it raises the risk of. Second, the fundamentals of care now explicitly include healthy eating, what the authors call “24 h physical behaviours” including sleep, avoiding tobacco and substance use, psychological support, and weight management interventions. Third, it advocates earlier use, potentially from diagnosis, of SGLT2 inhibitors and/or GLP-1-based therapies for organ protection and better long-term outcomes. Fourth, it says combining the two classes earlier should be considered in people who also have cardiovascular disease, chronic kidney disease or heart failure.
What changes, and what we could not read
The previous version, published in 2022, already placed weight management at the centre of care and recommended these two drug classes for people with established heart or kidney disease. The 2026 abstract goes further on timing: earlier use, potentially from diagnosis, moves the question from which patients qualify to when treatment starts. The phrase “GLP-1-based therapies” is broad enough to cover dual agonists such as tirzepatide as well as semaglutide; which drugs the panel names, and in what order, is set out in the full text.
What is not yet known. The publisher’s site blocked automated access and the full text was not available to us, so this report is based on the published abstract, and we have not characterised recommendations we have not read. A consensus report is expert judgement built on a literature review, not a new trial. It was funded by the two associations, and many of its authors disclose consulting, advisory or research relationships with Eli Lilly, Novo Nordisk and other makers of these drugs. A recommendation also does not settle coverage: whether insurers pay for earlier use is a separate question, and our cost guide covers what these drugs cost without it.
Sources: 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 2 October 2026 (abstract read via PubMed 42825923).
