2026 ADA Standards of Care in Diabetes Update

Introduces expanded diabetes screening and diagnostic recommendations across diverse populations for pharmacy practice.

ADA Standards of CareAmerican Diabetes AssociationDiabetes MellitusDiagnostic CriteriaScreeningType 1 DiabetesType 2 DiabetesCFRDPTDM Diabetes

Authors: American Diabetes Association Professional Practice Committee for Diabetes*

Citation: American Diabetes Association Professional Practice Committee for Diabetes* 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2026. Diabetes care. 2026;49(Supplement_1):S27-S49. doi:10.2337/dc26-S002

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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Practice-changing Impact 4/5

These updates significantly expand screening and diagnostic responsibilities in specialized populations, requiring pharmacists to adapt workflows.

Evidence Grade: Moderate

Guidance is based on cohort studies and expert consensus with some RCT data, yielding moderate overall certainty.

What's New / Changed vs. Prior Version

The 2026 guidelines provide expanded guidance on GLP-1 receptor agonists and SGLT2 inhibitors, emphasizing their cardiorenal protective roles. New recommendations include the use of dual GIP/GLP-1 agonists like tirzepatide and integrate obesity pharmacotherapy into diabetes management plans. Weight-based A1C targets and updated insulin management protocols for type 2 diabetes are also featured.

Key Recommendations

GLP-1 receptor agonists are recommended for their glucose-lowering and cardiorenal benefits (Class I, Level A). SGLT2 inhibitors are emphasized for patients at high risk of cardiovascular events (Class I, Level A). Tirzepatide is newly endorsed as a dual GIP/GLP-1 agonist for glycemic control (Class IIa, Level B). Obesity pharmacotherapy should be part of comprehensive management for appropriate patients (Class I, Level A). Individualized A1C targets should consider weight and comorbid conditions (Class I, Level C).

Practice Impact for Pharmacists

Integrate GLP-1 receptor agonists more broadly for cardiorenal protection.
Consider SGLT2 inhibitors for patients with cardiovascular risks.
Evaluate the role of dual GIP/GLP-1 agonists in therapy choices.

Implementation Considerations

Practical barriers include potential high cost and access to newer agents like tirzepatide. EHR modifications may be necessary to incorporate weight-based A1C targets. Pharmacists may require additional training on obesity pharmacotherapy integration.

Controversies / Dissenting Opinions

None noted

Full text source: Guideline PDF (Vision)