Guideline registry — type 1 diabetes¶
Last checked: 2026-08-30
Master table¶
| Body | Year | Region | Scope | Citation/URL | Status |
|---|---|---|---|---|---|
| ADA | 2026 | USA/global use | Diagnosis/classification | PMID 41358893 | current annual chapter |
| ADA | 2026 | USA/global use | Diabetes technology | PMID 41358889 | current annual chapter |
| ADA | 2026 | USA/global use | Pharmacologic glycemic treatment | PMID 41358900 | current annual chapter |
| ISPAD | 2024 | International | Screening, staging, β-cell preservation | PMID 39662065 | current |
| ISPAD | 2024 | International | Pediatric glycemic targets | PMID 39701064 | current |
| ISPAD | 2022 | International | DKA and HHS | PMID 36250645 | current domain chapter |
| ISPAD | 2022 | International | Psychological care | PMID 36464988 | current domain chapter |
| ISPAD | 2022 | International | Exercise | PMID 36537529 | current domain chapter |
| ISPAD | 2022 | International | Micro-/macrovascular complications | PMID 36537531 | current domain chapter |
| ISPAD | 2022 | International | Insulin treatment | PMID 36537533 | current domain chapter |
| ISPAD | 2022 | International | Diabetes education | PMID 36120721 | current domain chapter |
| ISPAD | 2022 | International | Hypoglycemia | PMID 36537534 | current domain chapter |
| ISPAD | 2022 | International | Nutrition | PMID 36468223 | current domain chapter |
| ISPAD | 2022 | International | Glucose monitoring technology | PMID 36537528 | superseded for this topic by 2024 update |
| ISPAD | 2022 | International | Ramadan/religious fasting | PMID 36537522 | current domain chapter |
| ISPAD | 2024 | International | Glucose monitoring technology | PMID 39884260 | current; supersedes 2022 monitoring chapter |
| JDRF/expert consensus | 2024 | International | Monitoring IAb-positive pre-stage-3 T1D | PMID 38912694 | current consensus |
| NICE NG17 | updated online | England/Wales | Adults with T1D | https://www.nice.org.uk/guidance/ng17 | current; accessed 2026-08-30 |
| NICE NG18 | updated online | England/Wales | Diabetes in children/young people | https://www.nice.org.uk/guidance/ng18 | current; accessed 2026-08-30 |
| International consensus | 2019 | International | CGM time-in-range targets | PMID 31177185 | current framework |
| International consensus | 2019 | International | DKA mitigation with SGLT inhibitors | PMID 30728224 | current risk framework; regulatory context varies |
| JDRF/Endocrine Society/ADA | 2015 | International/USA | Presymptomatic staging | PMID 26404926 | foundational; elaborated by 2024 guidance |
Per-guideline notes¶
ADA Standards of Care 2026¶
Annual modular standard. The technology chapter incorporates CGM and AID; diagnosis/classification addresses autoimmune diabetes across ages; the pharmacologic chapter maintains insulin as essential therapy (PMID 41358889; PMID 41358893; PMID 41358900).
ISPAD 2024 early-stage guideline¶
Translates screening, staging, and β-cell-preservation evidence to children and adolescents. It supersedes older pediatric early-stage summaries for these topics (PMID 39662065).
ISPAD 2022/2024 domain chapters¶
DKA/HHS, psychosocial care, exercise, complication screening, insulin treatment, diabetes education, hypoglycemia, nutrition, and religious fasting remain discrete operational chapters (PMID 36250645; PMID 36464988; PMID 36537529; PMID 36537531; PMID 36537533; PMID 36120721; PMID 36537534; PMID 36468223; PMID 36537522). The 2024 glucose-monitoring update supersedes the 2022 monitoring chapter for device-specific monitoring guidance (PMID 39884260; PMID 36537528).
NICE NG17 and NG18¶
Live NICE pages were fetched on 2026-08-28. NG17 covers adult diagnosis and management; NG18 covers children and young people. Their NHS implementation and cost context differs from ADA/ISPAD.
Supersession chains¶
- 2015 staging statement (PMID 26404926) → retained and operationalized by ISPAD 2024 (PMID 39662065) and monitoring consensus (PMID 38912694).
- Earlier annual ADA Standards → superseded by 2026 annual chapters (PMID 41358889; PMID 41358893; PMID 41358900).
- Earlier ISPAD pediatric domain chapters → superseded topic-by-topic by 2022/2024 chapters listed above.
- ISPAD 2022 glucose monitoring (PMID 36537528) → ISPAD 2024 glucose monitoring (PMID 39884260); related insulin, nutrition, and hypoglycemia chapters remain separately current.
Scope and target comparison¶
| Decision | ADA 2026 | ISPAD 2022/2024 | International consensus/NICE | Synthesis rule |
|---|---|---|---|---|
| Adult autoimmune classification | Explicit annual diagnosis chapter (PMID 41358893) | Pediatric focus | NICE NG17 is adult NHS guidance | Do not extrapolate pediatric screening pathways unchanged to adults |
| Pediatric early stages | General standards plus approved therapy context | Dedicated 2024 screen/stage/preserve chapter (PMID 39662065) | Monitoring consensus operationalizes IAb-positive follow-up (PMID 38912694) | Stage definitions agree; implementation strength differs |
| CGM/AID | Annual technology recommendations (PMID 41358889) | Dedicated 2024 glucose-monitoring chapter (PMID 39884260) | 2019 TIR framework supplies common metrics (PMID 31177185) | Separate target consensus from funding/eligibility policy |
| Insulin regimen | Annual pharmacologic chapter (PMID 41358900) | Pediatric insulin chapter (PMID 36537533) | NICE specifies NHS implementation | Preserve age, formulary, and health-system context |
| Hypoglycemia | Cross-cutting annual recommendations | Pediatric operational chapter (PMID 36537534) | TIR consensus quantifies low exposure | Biochemical targets do not replace severe-event assessment |
| DKA | Cross-cutting acute-care standards | Detailed pediatric DKA/HHS chapter (PMID 36250645) | SGLT consensus addresses a narrow adjunctive-drug risk (PMID 30728224) | Do not generalize SGLT mitigation into ordinary DKA management |
| Nutrition/fasting | General annual principles | Dedicated nutrition and fasting chapters (PMID 36468223; PMID 36537522) | Local religious and food contexts matter | Individualize without implying that one diet prevents autoimmunity |
Disagreements and gaps¶
| Topic | Agreement | Gap/disagreement |
|---|---|---|
| Population antibody screening | Early detection can reduce acute presentation | Universal implementation and cost-effectiveness unsettled |
| Teplizumab | Stage-2 delay established | Access, repeat dosing, long-term value unsettled |
| CGM/AID | Strong glycemic benefit | Funding, eligibility and implementation differ |
| Targets | Lower exposure is desirable when safe | Exact targets vary by age, risk and resources |
| SGLT adjuncts | DKA risk requires ketone mitigation | Approvals and acceptable net benefit differ |
| Retinal screening | Screening is essential | Interval individualization varies |
| Adult early-stage thresholds | Autoimmune diabetes can begin at any age | Most staging operational detail is pediatric |
| Technology evidence | RCTs consistently improve TIR | Device rankings rely on indirect and rapidly aging comparisons |
| Psychosocial screening | Routine assessment endorsed | Instruments, thresholds, referral capacity, and outcome expectations vary |
| Religious fasting | Risk assessment and individualized planning are necessary | Whether and how to fast depends on age, control, technology, setting, and observance |
Watch list¶
- Annual ADA 2027 Standards.
- ISPAD updates to technology, insulin, nutrition, and sick-day chapters.
- PubMed E-utilities title/date searches rerun on 2026-08-30 returned no topic-specific 2024–2026 ISPAD replacements for the 2022 insulin, nutrition, hypoglycemia, fasting, or diabetes-education chapters; repeat this dated search at the next audit rather than treating current status as permanent.
- NICE surveillance or replacement of NG17/NG18.
- Formal population-screening recommendations after ongoing programs.
- Post-approval teplizumab monitoring and repeat-course guidance.