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Peer-reviewedCC BY 4.0Diabetologia

2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes

  • Jane Speight1,2,3
  • Norbert Hermanns4
  • Walther Jensen5
  • Karin Kanc6
  • Thomas Karagiannis7
  • Michelle Law8
  • Andreia Mocan9
  • Femke Rutters10
  • Jackie Sturt11
  • Francesco Zaccardi12
  • Richard I. G. Holt13,14
14 affiliations
  1. 1School of Psychology, Deakin University, Geelong, VIC Australia
  2. 2Institute for Health Transformation, Deakin University, Geelong, VIC Australia
  3. 3The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, VIC Australia
  4. 4Research Institute of the Diabetes Academy Mergentheim (FIDAM), Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
  5. 5Copenhagen, Denmark
  6. 6jazindiabetes (Diabetes & Me), Diabetes Centre, Ljubljana, Slovenia
  7. 7Clinical Research and Evidence-Based Medicine Unit, Second Medical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
  8. 8Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
  9. 9Center for Diabetes, Nutrition and Metabolic Diseases, Emergency Clinical County Hospital, Cluj-Napoca, Romania
  10. 10Amsterdam UMC, location VUmc, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
  11. 11Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, London, UK
  12. 12Leicester Real World Evidence Unit, Leicester Diabetes Centre, University of Leicester, Leicester, UK
  13. 13Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
  14. 14Diabetes Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Abstract

Diabetes distress is the emotional burden that arises from living with, and self-managing, diabetes. The aim of this clinical guideline is to optimise the assessment and management of diabetes distress among adults with type 1 diabetes or type 2 diabetes, promoting consistent, person-centred care. The guideline was developed using the EASD Standard Operating Procedure, GRADE methodology and RIGHT reporting standards. A multidisciplinary Guideline Development Panel, including lived experience experts, formulated clinical questions using the PICOT framework. Two clinical questions were addressed: (1) optimal approaches and timing for identifying and exploring diabetes distress; (2) the effectiveness of psychological, psychoeducational, educational, peer support and technology-based interventions for reducing diabetes distress. Good Practice Statements on assessment were informed by de novo realist reviews. GRADE recommendations on management were derived from a commissioned systematic review and meta-analyses of RCTs. For adults with type 1 diabetes or type 2 diabetes, eight Good Practice Statements emphasise routine discussion of emotional well-being, use of validated tools, ongoing monitoring, collaborative care planning, documentation and availability of psychological support. For adults with type 1 diabetes, conditional GRADE recommendations support psychological interventions, continuous glucose monitoring and automated insulin delivery systems for reducing diabetes distress. For adults with type 2 diabetes, conditional GRADE recommendations support psychological, psychoeducational and educational interventions for reducing diabetes distress. The strengths of this guideline include its rigorous methodology and strong stakeholder engagement. Limitations include the scarcity of high-quality trials, particularly in low- and middle-income countries, and exclusion of non-randomised evidence. Implementation will require training and system-level support for integration into routine care, in addition to dissemination through peer-reviewed publications and open access formats.

Graphical Abstract:

Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06840-0.

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Cite

BibTeXRIS
BibTeX
@article{speight20262026,
  title = {{2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes}},
  author = {Jane Speight and Norbert Hermanns and Walther Jensen and Karin Kanc and Thomas Karagiannis and Michelle Law and Andreia Mocan and Femke Rutters and Jackie Sturt and Francesco Zaccardi and Richard I. G. Holt},
  journal = {Diabetologia},
  year = {2026},
  month = sep,
  doi = {10.1007/s00125-026-06840-0},
  url = {https://doi.org/10.1007/s00125-026-06840-0},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - 2026 EASD evidence-based clinical practice guideline for assessing and managing diabetes distress among adults with type 1 diabetes or type 2 diabetes
AU  - Jane Speight
AU  - Norbert Hermanns
AU  - Walther Jensen
AU  - Karin Kanc
AU  - Thomas Karagiannis
AU  - Michelle Law
AU  - Andreia Mocan
AU  - Femke Rutters
AU  - Jackie Sturt
AU  - Francesco Zaccardi
AU  - Richard I. G. Holt
PY  - 2026
DA  - 2026/09/15
JO  - Diabetologia
DO  - 10.1007/s00125-026-06840-0
UR  - https://doi.org/10.1007/s00125-026-06840-0
AB  - Diabetes distress is the emotional burden that arises from living with, and self-managing, diabetes. The aim of this clinical guideline is to optimise the assessment and management of diabetes distress among adults with type 1 diabetes or type 2 diabetes, promoting consistent, person-centred care. The guideline was developed using the EASD Standard Operating Procedure, GRADE methodology and RIGHT reporting standards. A multidisciplinary Guideline Development Panel, including lived experience experts, formulated clinical questions using the PICOT framework. Two clinical questions were addressed: (1) optimal approaches and timing for identifying and exploring diabetes distress; (2) the effectiveness of psychological, psychoeducational, educational, peer support and technology-based interventions for reducing diabetes distress. Good Practice Statements on assessment were informed by de novo realist reviews. GRADE recommendations on management were derived from a commissioned systematic review and meta-analyses of RCTs. For adults with type 1 diabetes or type 2 diabetes, eight Good Practice Statements emphasise routine discussion of emotional well-being, use of validated tools, ongoing monitoring, collaborative care planning, documentation and availability of psychological support. For adults with type 1 diabetes, conditional GRADE recommendations support psychological interventions, continuous glucose monitoring and automated insulin delivery systems for reducing diabetes distress. For adults with type 2 diabetes, conditional GRADE recommendations support psychological, psychoeducational and educational interventions for reducing diabetes distress. The strengths of this guideline include its rigorous methodology and strong stakeholder engagement. Limitations include the scarcity of high-quality trials, particularly in low- and middle-income countries, and exclusion of non-randomised evidence. Implementation will require training and system-level support for integration into routine care, in addition to dissemination through peer-reviewed publications and open access formats.  Graphical Abstract:  Supplementary Information: The online version contains peer-reviewed but unedited supplementary material available at https://doi.org/10.1007/s00125-026-06840-0.
SN  - 0012-186X
SN  - 1432-0428
ER  -