Diabetes Q&A

ADA/EASD Release Updated Joint Diabetes Recommendations

The European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) have released an updated consensus statement on the management of hyperglycemia in patients with type 2 diabetes. 


The new recommendations update the 2015 guidelines and come following a systematic review of literature available since 2014.


Among the recommendations:

  • All patients should have ongoing access to diabetes self-management education.
  • Medical nutrition therapy should be offered.
  • Overweight patients with diabetes should be advised of the benefits of weight loss and encouraged to take part in lifestyle management programs.
  • Increased activity, which improves glycemic control, should be encouraged in patients with type 2 diabetes.
  • Metformin continues to be the first-line recommendation for all patients with type 2 diabetes.
  • The selection of medication added to metformin is based on patient preference and clinical characteristics.
  • For patients with chronic kidney disease (CKD) or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit should be considered.

“The management of hyperglycemia in type 2 diabetes has become extraordinarily complex with the number of glucose-lowering medications now available. Patient-centered decision making and support and consistent efforts to improve diet and exercise remain the foundation of all glycemic management. Initial use of metformin, followed by addition of glucose-lowering medications based on patient comorbidities and concerns is recommended as we await answers to the many questions that remain,” they concluded.


—Michael Potts




  1. New EASD-ADA consensus guidelines on managing hyperglycaemia in type 2 diabetes launched at EASD meeting. New recommendations include specific drug classes for some patients and enhancing medication adherence [press release]. October 5, 2018. https://diabetologia-journal.org/2018/10/05/new-easd-ada-consensus-guidelines-on-managing-hyperglycaemia-in-type-2-diabetes-launched-at-easd-meeting-new-recommendations-include-specific-drug-classes-for-some-patients-and-enhancing-medication-a/.
  2. Davies MJ, D’Alessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) [published online October 5, 2018]. Diabetologia. https://link.springer.com/article/10.1007/s00125-018-4729-5.