World Diabetes Day 2026: “Early action on diabetes” – what has changed in practice

World Diabetes Day on 14 November 2026 runs under the theme "Early action on diabetes" ([1]). The International Diabetes Federation (IDF) has set this theme for 2026–27, with the campaign focused on early diagnosis and risk reduction ([1]). The WHO uses the same theme and adds access to comprehensive care and reducing diabetes stigma to the call for earlier diagnosis ([2]).

Why "early"? According to the IDF, up to 50% of people with type 2 diabetes already have complications when they are diagnosed ([1]).

At a glance

• Theme 2026–27: "Early action on diabetes", focused on early diagnosis and risk reduction ([1]).
• Prevalence: 589 million adults (20–79 years) live with diabetes – nearly one in nine adults ([3]).
• Undiagnosed: an estimated 252 million of them do not know they have it – over 4 in 10 ([3]).
• Projection: 853 million adults with diabetes by 2050 ([3]).
• What has changed: cardiorenal protection independent of glucose control ([5]), CGM from diagnosis ([6]), and an EU-authorised therapy that delays stage 3 type 1 diabetes ([8]).

The numbers: IDF Diabetes Atlas, 11th edition

The 11th edition of the IDF Diabetes Atlas was released in April 2025 ([3]). It estimates that 589 million adults aged 20–79 live with diabetes, of whom an estimated 252 million are not yet aware of it ([3]). Type 2 diabetes accounts for over 90% of all diabetes, 3 in 4 adults with diabetes live in low- and middle-income countries, and diabetes is responsible for over 3.4 million deaths each year ([3]). 1 in 8 adults is at high risk of developing type 2 diabetes ([3]).

The WHO uses a different age range (adults aged 18 and over) and counts 830 million people with diabetes in 2022, or 14% of adults ([4]). More than half of people living with diabetes took no diabetes medication in 2022 ([4]).

Five practice points

1. Look for it, don't wait for it

The 2023 ESC Guidelines on cardiovascular disease in patients with diabetes recommend systematic screening for diabetes in all patients with cardiovascular disease ([5]). The guideline notes that HbA1c or fasting glucose predict vascular complications more strongly than the 2-hour OGTT ([5]). An HbA1c ≥48 mmol/mol (≥6.5%) or a fasting glucose ≥7.0 mmol/L (≥126 mg/dL) is diagnostic of diabetes ([5]). To switch between units: HbA1c converter and glucose converter.

2. Cardiorenal protection – independent of HbA1c

In type 2 diabetes with atherosclerotic cardiovascular disease (ASCVD), the ESC recommends GLP-1 receptor agonists (GLP-1 RAs) and/or SGLT2 inhibitors to reduce cardiovascular risk, independent of glucose control ([5]). GLP-1 RAs are named as a preferred glucose-lowering therapy in this group, independent of background metformin use ([5]). In chronic heart failure, SGLT2 inhibitors are recommended regardless of left ventricular ejection fraction to reduce hospitalisation ([5]). In diabetes with chronic kidney disease, the guideline recommends an SGLT2 inhibitor and/or finerenone, together with regular screening using eGFR and the urine albumin-to-creatinine ratio (UACR) ([5]). Drug profiles for reference: metformin, semaglutide, empagliflozin.

3. Estimate risk with SCORE2-Diabetes

For people with type 2 diabetes without ASCVD or severe target-organ damage, the ESC introduces SCORE2-Diabetes, a dedicated 10-year cardiovascular risk score ([5]). Where the 10-year risk is 10% or higher, the guideline also provides for an SGLT2 inhibitor or GLP-1 RA, as a level C recommendation ([5]).

4. CGM from diagnosis

The American Diabetes Association's Standards of Care 2026 recommend continuous glucose monitoring (CGM) at diabetes onset and at any time afterwards for anyone who could benefit ([6]). They also remove previous prerequisites for starting an insulin pump or automated insulin delivery (AID) ([6]).

5. Type 1 diabetes: know the stages

Type 1 diabetes progresses in three stages, and symptoms normally appear only at stage 3 ([7]). In 2026 the ADA expanded its guidance on screening and monitoring people at risk of type 1 diabetes ([6]). In the EU, teplizumab has been authorised since 8 January 2026 to delay the onset of stage 3 type 1 diabetes in adults and children aged 8 years and older with stage 2 disease ([8]). In the placebo-controlled trial behind the approval, which enrolled 76 patients, median time to stage 3 was 50 months with teplizumab and 25 months with placebo ([7]). It is given as an intravenous infusion once daily for 14 consecutive days; the most frequent serious adverse reaction was cytokine release syndrome, in 2% of patients ([7]). Price and reimbursement are decided by each Member State ([7]).

What "early action" means at the bedside

According to the WHO, more than 40% of people with diabetes worldwide are undiagnosed ([2]). In daily practice the theme translates into three habits that follow directly from the ESC guideline: think of diabetes in patients with cardiovascular disease, check the kidneys with eGFR and UACR, and choose therapy by cardiorenal profile rather than by HbA1c alone ([5]).

This article is for information for health professionals and students. It does not replace guidelines or the summary of product characteristics and gives no recommendations for individual patients.

Sources

1. International Diabetes Federation. World Diabetes Day – Early action on diabetes (theme 2026–27): https://worlddiabetesday.org/
2. World Health Organization. World Diabetes Day 2026 – Early action on diabetes: https://www.who.int/campaigns/world-diabetes-day/2026
3. International Diabetes Federation. Over 250 million people worldwide unaware they have diabetes, according to new IDF research (IDF Diabetes Atlas, 11th edition), 7 April 2025: https://idf.org/news-and-resources/news/idf-diabetes-atlas-11th-edition/
4. World Health Organization. Diabetes – Fact sheet: https://www.who.int/news-room/fact-sheets/detail/diabetes
5. Marx N, Federici M, Schütt K, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J 2023;44(39):4043–4140. https://academic.oup.com/eurheartj/article/44/39/4043/7238227
6. American Diabetes Association. American Diabetes Association Releases Standards of Care in Diabetes—2026, 8 December 2025: https://diabetes.org/newsroom/press-releases/american-diabetes-association-releases-standards-care-diabetes-2026
7. European Medicines Agency. First-in-class treatment to delay onset of type 1 diabetes, 14 November 2025: https://www.ema.europa.eu/en/news/first-class-treatment-delay-onset-type-1-diabetes
8. European Medicines Agency. Teizeild (teplizumab) – EPAR: https://www.ema.europa.eu/en/medicines/human/EPAR/teizeild