On 2 October 2026, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published their updated consensus report on the management of type 2 diabetes in non-pregnant adults. [1]
Building on the 2022 report, which already emphasised holistic care, weight management and heart and kidney protection, the 2026 update further broadens the focus to associated long-term conditions and whole-body health.
HbA1c remains important, but effective diabetes care also considers body weight, cardiovascular and kidney health, the liver, sleep, movement and overall metabolic wellbeing.
Lifestyle Is the Foundation
Healthy lifestyle habits are a fundamental part of diabetes management. They include a healthy and sustainable diet, regular activity, strength training, less sedentary time, good sleep, weight management, avoiding smoking and harmful substance use, and support for psychological wellbeing.
The report reinforces the “five S’s”, a practical framework for physical behaviours across the full 24-hour day: [1]
- Standing — spend less time sitting and stand up regularly.
- Stepping — walk and move more throughout the day.
- Sweating — include aerobic activity suited to your ability.
- Strengthening — maintain strength through resistance training.
- Sleep — prioritise sufficient, regular sleep.
Diabetes management is therefore part of daily life, extending beyond meals and medication.
Weight Management Is a Major Treatment Goal
For people with type 2 diabetes who also have overweight or obesity, weight loss is an important treatment goal. It can improve blood glucose, insulin sensitivity, blood pressure, blood lipids and other aspects of metabolic health.
Some people, particularly earlier in the course of type 2 diabetes, may achieve remission after substantial and sustained weight loss. For suitable individuals, intensive lifestyle support aiming for weight loss of 10% or more may increase this possibility. [2]
Remission does not mean a permanent cure. Continued follow-up is needed, and weight-loss goals and treatment should be tailored to the individual.
Treatment Goals Extend Beyond Blood Glucose
Type 2 diabetes often coexists with obesity, high blood pressure, abnormal blood lipids, cardiovascular disease, chronic kidney disease, fatty liver disease, obstructive sleep apnoea, reduced muscle mass, and psychological or emotional difficulties.
Care should therefore reflect each person’s health conditions, needs and preferences. The same treatment pathway will not be appropriate for everyone.
Earlier Consideration of Organ-Protective Medication
SGLT2 inhibitors and GLP-1-based therapies have changed diabetes treatment. In addition to lowering blood glucose, certain medicines have demonstrated cardiovascular and kidney benefits in relevant patient groups. Some also support weight management.
The 2026 report advocates considering these treatments earlier, potentially from diagnosis, according to the person’s clinical situation. Earlier combination treatment may also be considered when cardiovascular disease, chronic kidney disease or heart failure is present. [1]
The benefits vary between medicines and conditions. Selection should take account of indications, kidney function, adverse effects, contraindications, affordability and individual preferences, in discussion with the clinician responsible for diabetes care.
Liver Health Is Part of Diabetes Care
Type 2 diabetes is closely associated with metabolic dysfunction-associated steatotic liver disease (MASLD). Liver health is therefore an important part of comprehensive assessment and management. [1]
For people living with type 2 diabetes, obesity and fatty liver disease, weight management, nutrition, physical activity and appropriate medication may all form part of an individual care plan. Assessment should also consider the risk of liver fibrosis.
From Improving a Number to Improving Overall Health
Modern diabetes care asks more than “What is my blood sugar?” It also considers whether glucose is safely managed, weight goals are appropriate, insulin resistance and metabolic risks are addressed, and the heart, kidneys and liver are protected.
Nutrition, muscle strength, everyday activity, sleep and psychological wellbeing all contribute to the wider picture.
Type 2 diabetes requires coordinated management across these areas. Earlier attention to these foundations can support long-term health.
This article is general health information. Diabetes diagnosis, medication and follow-up should be managed with your doctor. Lifestyle support complements medical care.