New EASD guideline combines clinical standards with lived experience

The guideline was developed in line with internationally recognized standards, including the GRADE methodology and the RIGHT reporting statement, and reflects the EASD's newly established Standard Operating Procedures for guideline development.

Importantly, people with lived experience of type 1 diabetes and type 2 diabetes were active members of the Guideline Development Panel from the outset. Their contributions helped shape the clinical questions, interpretation of evidence, and formulation of recommendations, ensuring that the final guideline is firmly grounded in the real-world needs and priorities of adults with diabetes.

The publication of this first EASD guideline is a landmark moment for our Association and for the international diabetes community. Assessing and managing diabetes distress is as vital as assessing and managing glucose levels – and it is this recognition that makes the present guideline so important for both clinical practice and future research to improve the lives of people with diabetes."

Apostolos Tsapas, Professor, Aristotle University of Thessaloniki

Tsapas is also the Chair of the EASD Guidelines Oversight Committee.

Key recommendations

Recognising the emotional burden of diabetes as a critical component of care, the guideline provides Good Practice Statements for routine assessment of diabetes distress and evidence-based recommendations for its management.

• Assessment: Healthcare professionals are encouraged to routinely ask about and assess diabetes distress during consultations. Good Practice Statements recommend discussing the emotional side of diabetes at every appointment, using open-ended questions, and using valid, reliable assessment tools. Regular monitoring is advised as part of the annual cycle of care, with results recorded in clinical notes and discussed openly with the person with diabetes. When distress is identified, healthcare professionals should work together with the individual to agree on next steps, ensuring follow-up support is tailored and person-centred.
• Management: Evidence-based recommendations support the use of psychological and psychoeducational interventions to reduce diabetes distress, with specific guidance varying according to diabetes type and intervention category. While research gaps remain, the guideline underlines the value of structured support – ranging from psychological therapies to peer support and technology-based interventions – in improving emotional well-being and self-care.

A milestone in diabetes care

The launch of this guideline marks a turning point in recognising and addressing the emotional challenges of living with diabetes. Although major advances in treatment and technology have transformed care, many people continue to experience significant emotional and psychological burden in managing the relentless demands of the condition.

Professor Richard Holt, University of Southampton & University Hospital Southampton NHS Foundation Trust in the United Kingdom and Co-Chair of the Guideline Development Panel, said: "We are proud that the EASD has chosen diabetes distress for its first-ever evidence-based clinical guideline. This decision affirms the importance of emotional health alongside physical health for people with diabetes."

Professor Jane Speight, The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria and Deakin University in Australia and Co-Chair of the Guideline Development Panel, said: "We hope that this guideline will empower healthcare professionals to routinely assess and address the emotional burden of living with diabetes, ultimately improving outcomes for adults with type 1 and type 2 diabetes across Europe and beyond."

Professor Chantal Mathieu, Katholieke Universiteit Leuven in Belgium and President of the European Association for the Study of Diabetes, added: "Despite huge advances in therapies and technologies, the emotional burden of diabetes has not diminished – and for many, it has increased. This guideline recognises that reality, reminding us that good diabetes care must address both glucose levels and the lived experience of managing the condition. I am immensely proud to present this first EASD clinical guideline, which reflects the best available evidence and the hard work of many colleagues. It is a milestone in ensuring that emotional well-being becomes a core part of diabetes care."

Implementation and dissemination

Successful implementation of the guideline will require training, system-level support, and integration into routine care. The EASD plans to support dissemination through peer-reviewed publication, open-access availability, and plain-language summaries designed for accessibility by people living with diabetes and the wider public.

The publication of this first guideline not only addresses an urgent and unmet need in diabetes care but also establishes a framework for future EASD guidelines. The Association is committed to publishing further clinical guidelines, thereby continuing to strengthen the evidence base for person-centred diabetes care.