The European Association for the Study of Diabetes publishes its first-ever clinical guideline and the world's first to focus on diabetes distress
The European Association for the Study of Diabetes (EASD) has published its first evidence-based clinical practice guideline, focussing on the assessment and management of diabetes distress in adults with type 1 diabetes or type 2 diabetes
European Association for the Study of Diabetes
Key recommendations
This guideline is official recognition that supporting people with the emotional burden of diabetes is a critical part of clinical care. The guideline sets out Good Practice Statements for the routine assessment of diabetes distress, together with evidence-based recommendations for its management.
- Assessment: Eight Good Practice Statements highlight that healthcare professionals should discuss the emotional side of diabetes at every consultation as an integral part of person-centred diabetes care. They should ask about and assess diabetes distress using open-ended questions and valid, reliable assessment tools. Regular monitoring is recommended at least annually, as part of the annual cycle of care, but also during significant life events or treatment changes. Findings should be documented in the clinical notes and discussed openly with the person with diabetes. Where distress is identified, healthcare professionals should make a joint plan with the person about next steps, and ensure follow-up support is tailored and person-centred. Healthcare professionals involved in the care of people with diabetes should have the competency to offer psychological support to those experiencing diabetes distress and know how to enlist specialist support when needed.
- Management: Evidence-based recommendations support the use of psychological and psychoeducational interventions to reduce diabetes distress, with specific guidance differing according to diabetes type and intervention category. For adults with type 1 diabetes, the use of continuous glucose monitoring and automated insulin delivery is recommended, over other methods of glucose monitoring or insulin delivery, for reducing diabetes distress, but the evidence does not support the use of advanced technologies for reducing diabetes distress among adults with type 2 diabetes. While gaps in research remain, the guideline underlines the value of structured support – from psychological therapies to peer support and technology-based interventions – in reducing the emotional burden of living with diabetes.
A milestone in diabetes care
The publication of this guideline marks a turning point in how the emotional challenges of living with diabetes are recognised and addressed. While major advances in treatment and technology have transformed care, many people continue to face a significant emotional and psychological burden in managing the relentless demands of the condition.
Professor Jane Speight, Director of The Australian Centre for Behavioural Research in Diabetes, at Diabetes Victoria and Deakin University, and Co-Chair of the Guideline Development Panel, commented: “We hope this guideline will persuade healthcare professionals of the importance of routinely assessing and addressing the emotional burden of living with diabetes, ultimately improving clinical care and outcomes among adults with type 1 and type 2 diabetes across Europe and beyond.”
Professor Richard Holt, University of Southampton & University Hospital Southampton NHS Foundation Trust in the United Kingdom and Co-Chair of the Guideline Development Panel, commented: “We are proud that the EASD has chosen diabetes distress as the focus of its first-ever evidence-based clinical guideline. This decision affirms that emotional health matters just as much as physical health for people with diabetes.”
Michelle Law, person living with type 1 diabetes and Honorary Professor at Exeter University in the United Kingdom: “Healthcare professionals sometimes mistake diabetes distress for depression. But it's different – these feelings relate specifically to managing a condition that never gives us a break and which we're handling alone for most of the time. We need a shift in how healthcare professionals approach people with diabetes. Mental health isn't separate from physical health – they directly impact each other."
Professor Francesco Giorgino, University of Bari Aldo Moro in Italy and President of the European Association for the Study of Diabetes, added: “Despite huge advances in therapies and technologies, the emotional burden of diabetes has not eased – for many, it has grown. This guideline acknowledges that reality, reminding us that good diabetes care must address both glucose levels and the lived experience of managing the condition. I am immensely proud of this first EASD clinical guideline, which reflects the best available evidence and the hard work of many colleagues. It marks a milestone in making emotional well-being a core part of diabetes care.”
Guideline development and inclusiveness
Developed in line with internationally recognised standards – including the GRADE methodology and the RIGHT reporting statement – the guideline reflects the EASD’s Standard Operating Procedures for guideline development. People with lived experience of type 1 diabetes and type 2 diabetes were involved as active members of the Guideline Development Panel from the outset, helping to shape the clinical questions, interpret the evidence, and formulate the recommendations. This ensures the guideline is firmly rooted in the real-world needs and priorities of adults living with diabetes.
Professor Apostolos Tsapas, Aristotle University of Thessaloniki in Greece and Chair of the EASD Guidelines Oversight Committee, commented: “Publishing this first EASD guideline is a landmark moment for our Association and for the international diabetes community. Assessing and managing diabetes distress matters just as much as assessing and managing glucose levels – and recognising this is what makes the guideline so important, both for clinical practice and for future research to improve the lives of people with diabetes.”
For full guideline, please click here
Implementation and dissemination
Successful implementation of the guideline will require training, system-level support, and integration into routine clinical care. The EASD is supporting its dissemination through open-access publishing and a plain-language summary designed to be accessible to people living with diabetes and the wider public.
Publishing this first guideline in Diabetologia, the official journal of the EASD, addresses an urgent and unmet need in diabetes care while also establishing a standard for future EASD guidelines. The Association remains committed to publishing further clinical guidelines – with two more already in development – continuing to strengthen the evidence base for person-centred diabetes care.
About EASD
The European Association for the Study of Diabetes (EASD) e.V. is a membership-based non-profit organisation with the mission to promote excellence in diabetes care through research, networking, and education. Its Annual Meeting is one of the largest diabetes conferences in the world, attracting thousands of delegates each year.
The EASD is a leader in education for healthcare professionals and develops statements and guidelines that translate the latest research into best practices in diabetes management. It publishes Diabetologia, a major monthly international journal with an impact factor of 10.4 (2025), and Metabologia, a new international, peer-reviewed, open-access journal.
In 2000, the EASD reinforced its commitment to European diabetes research by creating the European Foundation for the Study of Diabetes (EFSD), which has since committed over €130 million to research.
For more information, please visit: www.easd.org
Journal
Diabetologia
Method of Research
Systematic review
Subject of Research
People
Article Title
2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes
Article Publication Date
15-Sep-2026
COI Statement
JSp has served on advisory boards for Sanofi and Vertex, for which her research centre (The Australian Centre for Behavioural Research in Diabetes [ACBRD]) has received honoraria. The ACBRD has also received unrestricted grants from Abbott, Lilly, Novo Nordisk and Sanofi to support the Global Summit to End Diabetes Stigma (Jaipur, India: March 2026), and sponsorship from Sanofi (unrestricted grant) to support the 30th PsychoSocial Aspects of Diabetes (PSAD) Study Group conference (Geelong, Australia: Feb 2026). NH has received advisory board fees from Abbott Diabetes Care and Dexcom and honoraria for lectures from Abbott Diabetes Care, Roche Diagnostics and Sanofi. TK received financial reimbursement from the EASD for his contribution as methodologist for this guideline and declares no conflicts of interest. FR received financial reimbursement from the EASD for execution of the systematic review and meta-analyses, which was commissioned and funded by the EASD to support the work of the Guideline Development Panel. She is a member of the editorial board of Diabetologia. JSt was a member of the Novo Nordisk Foundation Global Diabetes Forum between 2024 and 2025, during which in-person meeting attendance was supported. FZ received financial reimbursement from the EASD for his contribution as methodologist for this guideline and declares no conflicts of interest. RIGH has received honoraria for speaker engagements from Boehringer-Ingelheim, Eli Lilly, Encore, Liberum, Novo Nordisk and ROVI Pharma and consultancy fees from SPOTLIGHT-AQ. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.
No comments:
Post a Comment