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Guideline registry — type 1 diabetes¶
Last checked: 2026-10-22
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| ISPAD | 2022 | International | Glucose monitoring technology | PMID 36537528 | superseded for this topic by 2024 update |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 | 2015; last updated 17 August 2022 | England/Wales | Adults with T1D | https://www.nice.org.uk/guidance/ng17 | current; reviewed 30 January 2026 and recommendations will not be updated; Levemir (insulin detemir) discontinuation noted, anticipated supply end December 2026, impact on recommendations under assessment; accessed 2026-10-22 |
| NICE NG18 | 2015; last updated 11 May 2023 | England/Wales | Diabetes in children and young people | https://www.nice.org.uk/guidance/ng18 | current; reviewed 18 December 2025 and recommendations will not be updated; same Levemir supply note; accessed 2026-10-22 |
| 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 |
| ADA/EASD | 2026 | International; adults | Updated adult T1D consensus | PMID 42747450; correction PMID 42814152 | current update to 2021 report; C-peptide unit-label correction checked |
| International screening consensus | 2026 | International; predominantly pediatric evidence | General-population IAb screening | PMID 42720753 | current implementation guidance; complements 2024 monitoring consensus |
| EASD | 2026 | Adults with T1D or T2D | Assessment/management of diabetes distress | PMID 42744915 | current; distinguish recommendations by diabetes type and intervention |
| International inpatient technology group | 2026 | Non-critically ill adults | Inpatient CGM, pumps and AID | PMID 42771181 | current position statement; not pediatric or ICU guidance |
| AACE | 2026 | Adults with diabetes | Diabetes technology | PMID 42709002 | newly cataloged; abstract/metadata checked; full recommendation synthesis deferred |
| SED–SEEN–SEEP | 2026 | Spain | Integrated early-stage detection and follow-up pathway | PMID 42760247 | newly cataloged executive summary; full-text synthesis deferred |
| ISPAD/EASD/ADA | 2026 | International | Transition from pediatric to adult diabetes care | PMID 42784528; doi 10.1159/hrp/adaag005 | current consensus guide; PubMed type is Journal Article; 31 statements not individually synthesized because the full text was not open; does not replace the Campbell 2016 evidence review of transition interventions |
| NICE TA1176 | published 09 July 2026 | England | Teplizumab to delay stage 3 in people aged 8 years and over with stage 2 T1D | https://www.nice.org.uk/guidance/ta1176 | positive recommendation within the marketing authorisation, only if supplied under the commercial arrangement; NHS England funding statement on the recommendation page; no PMID found on PubMed; not new randomized evidence; accessed 2026-10-22 |
Per-guideline notes¶
September 2026 additions¶
The international population-screening consensus adds a schedule and implementation pathway. The adult ADA/EASD report updates its 2021 predecessor; its correction concerns C-peptide unit labeling. The EASD distress guideline and inpatient technology statement address distinct care settings, rather than replacing pediatric ISPAD chapters (PMID 42720753; PMID 42747450; PMID 42814152; PMID 42744915; PMID 42771181).
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 2026-10-22. NG17 covers adult diagnosis and management and was last updated 17 August 2022. Its page says it was reviewed on 30 January 2026 and that the recommendations will not be updated. NG18 covers children and young people and was last updated 11 May 2023. Its page says it was reviewed on 18 December 2025 and that the recommendations will not be updated. Both pages note that Levemir (insulin detemir) Penfill and Flexpen presentations are to be discontinued, with an anticipated supply end in December 2026, and that NICE is assessing the impact on the recommendations. Their NHS implementation and cost context differs from ADA/ISPAD.
October 2026 additions¶
The ISPAD/EASD/ADA transition report catalogs 31 locally adjustable statements across pre-transfer, transfer, and post-transfer. PubMed indexes it as a journal article. The full text was not open, so individual statements were not extracted (PMID 42784528). NICE TA1176 is an England funding recommendation for teplizumab in people aged 8 years and over with stage 2 type 1 diabetes. A PubMed search for "technology appraisal"[tiab] AND teplizumab[tiab] on 2026-10-22 returned no records, so TA1176 is cited by URL (https://www.nice.org.uk/guidance/ta1176, accessed 2026-10-22).
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 assessment of the Levemir (insulin detemir) discontinuation against NG17 and NG18 recommendations. Surveillance retrieved on 2026-10-22 did not update either guideline's recommendations.
- Formal population-screening recommendations after ongoing programs.
- Post-approval teplizumab monitoring and repeat-course guidance.
Sweep currency check — 2026-10-15¶
ADA's official landing page still presents the 2026 Standards; ISPAD's public guideline index presents its 2024 and 2022 collections. No newer Cochrane T1D review was returned by the dated PubMed searches. NICE NG17/NG18 fetches returned HTTP 403, so their current revision status was not verified in this sweep. Existing older chapter statuses above were not independently re-audited.
Sources retrieved: ADA — "Standards of Care in Diabetes", https://professional.diabetes.org/standards-of-care; ISPAD — "ISPAD Clinical Practice Consensus Guidelines", https://www.ispad.org/resources/ispad-clinical-practice-consensus-guidelines.html; accessed 2026-10-15.
Sweep currency check — 2026-10-22¶
The ADA standards page still presents the 2026 Standards of Care and does not present a 2027 edition (ADA — "Standards of Care in Diabetes", https://professional.diabetes.org/standards-of-care, accessed 2026-10-22). An older ISPAD path, https://www.ispad.org/resource-center/ispad-clinical-practice-guidelines.html, returned HTTP 404. The current guidelines index still lists the 2024, 2022, and 2018 collections and does not list a 2026 chapter set (ISPAD — "ISPAD Clinical Practice Consensus Guidelines", https://www.ispad.org/resources/ispad-clinical-practice-consensus-guidelines.html, accessed 2026-10-22). The homepage announces the Rio conference of 4–7 November 2026 and does not announce a chapter replacement. Dated PubMed searches for "Cochrane Database Syst Rev"[jour] across 16 topics, plus a condition-wide CDSR search, each returned count 0. That is a PubMed/CDSR finding. CENTRAL was not searched because cochranelibrary.com returned HTTP 403. NICE NG17, NG18, and TA1176 were readable on this date; the findings are in the table above. Older chapter statuses other than NG17 and NG18 were not independently re-audited.