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The American Diabetes Association® (ADA) released the “Standards of Care in Diabetes—2026” (Standards of Care), the gold standard in evidence-based guidelines for diagnosing and managing diabetes and prediabetes. Based on the latest scientific research and clinical trials, the Standards of Care includes strategies for diagnosing and treating diabetes in children, adolescents, and adults; methods to prevent or delay diabetes and its associated comorbidities like obesity; and care recommendations to enhance health outcomes.
“The 2026 ‘Standards of Care in Diabetes’ represents significant advancement in the delivery of evidence-based, person-centered care. These guidelines synthesize the latest scientific research with practical clinical strategies, thereby equipping health care professionals with the tools necessary to provide optimal care for individuals living with diabetes,” said Rita Kalyani, MD, MHS, the ADA’s chief scientific and medical officer.
Notable updates to the 2026 Standards of Care include:
Diabetes technology
- Recommended use of continuous glucose monitoring at diabetes onset and anytime thereafter to improve outcomes for anyone who could benefit from its use in diabetes management
- New guidance removing the need to meet certain treatment requirements before initiation of continuous subcutaneous insulin infusion or automated insulin delivery
Glucose-lowering medications
- New guidance on obesity pharmacotherapy dose individualization in people with diabetes
- New guidance on the treatment of obesity in people with type 1 diabetes
- New guidance on glucose-lowering therapies in people with chronic kidney disease, including use by those on dialysis
- Additional guidance on the use of glucose-lowering therapy beyond obesity and glycemic treatment, including heart, kidney, and liver health benefits
Nutrition
- Guidance on the eating patterns with evidence for preventing type 2 diabetes, including Mediterranean-style and low-carbohydrate eating patterns
- Emphasis on monitoring for adequate nutritional intake and expanded discussion on the importance of physical activity during obesity treatment
Diabetes management
- New guidance for glycemic management for individuals during cancer treatment and for those undergoing organ transplantation
- Updated blood pressure goals for individuals with high cardiovascular or kidney health risk and for older adults, with a tighter blood pressure goal for those at risk and a more relaxed goal for most older adults
- Expanded guidance on screening and monitoring individuals at risk for type 1 diabetes, including the utilization of diabetes technology
The ADA annually updates its Standards of Care through the efforts of its Professional Practice Committee (PPC) for Diabetes. This year the PPC was co-chaired by Mandeep Bajaj, MBBS, FRCP and Rozalina G. McCoy, MD, MS. Comprising global experts from diverse professional backgrounds, the PPC includes physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitian nutritionists, pharmacists, and methodologists. The committee holds expertise in a range of related fields. The 2026 Standards of Care has garnered endorsements from the following organizations:
- American Society for Bone and Mineral Research (Bone Health, Section 4)
- The Obesity Society (Section 8)
- American College of Cardiology (Section 10)
- National Kidney Foundation (Section 11)
- American Geriatrics Society (Section 13)
- International Society for Pediatric and Adolescent Diabetes (Section 14)
Other noteworthy changes include:
- Guidance on behavioral health screening and referral for concerns such as diabetes distress and anxiety
- Information on supporting diabetes technology use for children, adolescents, and adults in educational and workplace settings
- New and updated algorithms on insulin therapy in type 1 diabetes, prevention and treatment of symptomatic heart failure, and chronic kidney disease treatment and atherosclerotic cardiovascular disease prevention in people with type 2 diabetes
- New discussion on emerging technologies in foot care and information on adjunctive advanced therapies for diabetic foot ulcers
- Updated guidance for older adults, including continuous glucose monitoring use, protein intake, and assessing geriatric syndromes and functional impairments
- Updated guidance for children and adolescents, including nutrition education and screening for psychosocial concerns and complications associated with type 1 and type 2 diabetes
- Updated information on preconception counseling and appropriate non-insulin glucose-lowering therapy discontinuation
- New hospital guidance, including glycemic goals in the perioperative period and expanded discussion on technology use
“The Standards of Care is a vital part of the ADA’s efforts to improve the lives of all people affected by diabetes. It offers the trusted support needed for people living with diabetes and those caring for them while we continue to push toward a cure,” said Charles “Chuck” Henderson, the ADA’s chief executive officer.
The 2026 Standards of Care is now available online as a supplement to the January 2026 issue of Diabetes Care®. In addition, a convenient Standards of Care app, available for iOS and Android systems, offers the latest guidelines with interactive tables and algorithms for easy reference. Additional resources, including a comprehensive slide deck and a webcast offering CE credit, are available on the ADA’s professional website, DiabetesPro®.
A quick-reference pocket chart will soon be available for purchase on ShopDiabetes.org. For primary care professionals, the Abridged Standards of Care, developed by the ADA’s Primary Care Advisory Group, is planned for release in spring 2026 in Diabetes, Obesity, and Cardiometabolic CARE®. Through the “living” Standards of Care process, the online version, abridged guidelines, and all related materials will be updated in real time throughout the year to reflect the latest evidence and regulatory changes.
Information source: ADA
