Diabetes distress reflects the emotional burden associated with living with and managing diabetes. It affects a substantial proportion of adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Diabetes distress is distinct from depression, but unrecognized or persistent distress can adversely affect self-care behaviors, glycaemic outcomes, quality of life, and long-term health. The 2026 EASD clinical practice guideline for assessing and managing diabetes distress among adults with T1DM and T2DM provides structured, evidence-based recommendations to support timely identification, systematic assessment, and appropriate management of diabetes distress in routine clinical practice. The guideline emphasizes the integration of emotional care as a core component of high-quality diabetes management.

Good Practice Statements for Assessing Diabetes Distress in Adults with T1DM and T2DM

• Healthcare professionals should address the emotional impact of diabetes during every clinical consultation and incorporate this discussion as an integral component of person-centered diabetes care.
• Healthcare professionals should assess diabetes distress by asking open-ended questions that explore the emotional burden and day-to-day challenges associated with living with diabetes.
• Healthcare professionals should evaluate diabetes distress using a validated and reliable assessment instrument.
• Healthcare professionals should routinely assess and monitor diabetes distress at regular intervals as part of the annual diabetes care review.
• Healthcare professionals should acknowledge and discuss the individual’s assessment results, regardless of the outcome, to support effective person-centered care.
• Healthcare professionals should document the findings of the diabetes distress assessment in the clinical record and communicate these findings with relevant members of the multidisciplinary healthcare team.
• When healthcare professionals identify diabetes distress, they should collaborate with the person living with diabetes to develop an appropriate care plan outlining the next steps.
• General healthcare professionals and diabetes specialists should possess the competency to provide initial psychological support to individuals experiencing diabetes distress and recognize when referral to specialized psychological or mental health services is required.

GRADE and Ungraded Recommendations for Managing Diabetes Distress in Adults with T1DM

• Healthcare professionals may consider incorporating psychological interventions alongside usual care to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not routinely incorporate psychoeducational interventions in addition to usual care solely to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not routinely incorporate educational interventions in addition to usual care solely to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not routinely incorporate peer support interventions in addition to usual care solely to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not preferentially use psychological interventions instead of psychoeducational interventions, or vice versa, to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not preferentially use psychological interventions instead of educational interventions, or vice versa, to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not preferentially use psychoeducational interventions instead of educational interventions, or vice versa, to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should consider continuous glucose monitoring (CGM) rather than capillary glucose monitoring to reduce diabetes distress among adults with T1DM.
• Healthcare professionals should not use automated insulin delivery systems solely to reduce diabetes distress among adults with T1DM.

GRADE and Ungraded Recommendations for Managing Diabetes Distress in Adults with T2DM

• Healthcare professionals may consider psychological interventions in addition to usual care, rather than usual care alone, to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider psychoeducational interventions in addition to usual care, rather than usual care alone, to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider educational interventions in addition to usual care, rather than usual care alone, to reduce diabetes distress among adults with T2DM.
• Healthcare professionals should not routinely use peer support interventions in addition to usual care, rather than usual care alone, to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider either psychological or psychoeducational interventions to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider either psychological or educational interventions to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider psychoeducational interventions rather than educational interventions to reduce diabetes distress among adults with T2DM.
• Healthcare professionals may consider educational interventions rather than peer support interventions to reduce diabetes distress among adults with T2DM.
• Healthcare professionals should not use CGM instead of capillary glucose monitoring (finger prick testing) solely to reduce diabetes distress among adults with T2DM.