WHO issues first guideline on type 1 diabetes in adults

The World Health Organisation has recommended that people with type 1 diabetes receive insulin injections several times a day, with doses adjusted according to their blood glucose levels.

The recommendation is contained in its first-ever guideline on the diagnosis and management of type 1 diabetes in adults, more than a century after the discovery of insulin.

The guidelines, released on Saturday to mark World Diabetes Day 2026, are designed to guide the diagnosis and treatment of adults living with type 1 diabetes across different healthcare settings, including low-resource environments, emergencies and humanitarian crises.

WHO called for improved access to affordable insulin, regular blood glucose monitoring and quality diabetes care, particularly in countries and communities with limited healthcare resources.

The new guidelines come against the backdrop of a growing global burden of the condition, with millions of people still struggling to access the essential medicines and healthcare services required to manage it.

According to WHO, an estimated 9.5 million people were living with type 1 diabetes globally in 2025, while another 500,000 people were diagnosed with the condition within the same year.

Although type 1 diabetes has traditionally been associated with childhood, WHO noted that the condition is increasingly affecting adults.

It highlighted the need for healthcare systems to strengthen diagnosis and treatment services beyond paediatric care.

Type 1 diabetes is a lifelong condition in which the pancreas produces little or no insulin, a hormone that regulates blood glucose levels.

People living with the condition depend on daily insulin treatment to survive and must regularly monitor their blood glucose to prevent potentially life-threatening complications.

Speaking on the new recommendations, WHO Director of Noncommunicable Diseases and Mental Health, Dr Soren Brostrom, said access to affordable and quality insulin remained a major challenge, despite the treatment being discovered more than 100 years ago.

“Insulin is a lifesaving treatment, discovered more than 100 years ago. Yet many people with type 1 diabetes do not have access to affordable and high-quality insulin,” he said.

He explained that the guidelines provide evidence-based recommendations to help countries improve diabetes care.

According to WHO, they also ensure that people living with the condition receive appropriate treatment, even in settings where resources are limited and health services are disrupted.

Under the new recommendations, WHO advises that people with type 1 diabetes receive insulin through multiple daily injections, with doses adjusted according to their blood glucose levels.

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The guidelines identify human insulin, a manufactured medicine that works similarly to insulin naturally produced by the human body, as an appropriate and effective treatment option.

Other types of insulin may also be used where necessary, depending on individual needs and availability.

Beyond insulin treatment, WHO emphasises the importance of regular blood glucose monitoring as a critical component of managing the condition and reducing the risk of complications.

At healthcare facilities, it said monitoring may involve periodic blood tests that measure average blood glucose levels over the preceding few months.

At home, it recommends that patients monitor their blood glucose through finger-prick testing or continuous glucose monitoring systems, which use small sensors worn on the skin to track glucose levels.

In settings where blood glucose testing is unavailable, WHO said urine glucose testing may be considered as an alternative.

The recommendations are also intended to support WHO’s broader global targets for diabetes care, particularly the goal of ensuring that all people living with type 1 diabetes have access to affordable insulin treatment and blood glucose self-monitoring by 2030.

To translate the recommendations into practical improvements, WHO said it would support countries with implementation tools and guidance to monitor progress towards the targets.

The health agency also urged countries to involve people living with type 1 diabetes in the design, implementation and evaluation of diabetes programmes, recognising that patients’ experiences and needs should inform policies and healthcare delivery.

The release of the guidelines is particularly significant as the world marks World Diabetes Day 2026 with the theme, “Early action on diabetes”.

The theme underscores the importance of timely diagnosis, appropriate treatment and sustained management in preventing complications.

Diabetes, when left undiagnosed or inadequately managed, can lead to serious health complications, including blindness, kidney failure, heart attacks, strokes and lower-limb amputations.

WHO estimates that the global burden of diabetes has increased more than fourfold since 1990.

It noted that approximately 830 million people were living with diabetes worldwide in 2022, the majority of whom had type 2 diabetes.

WHO also highlighted a major gap in diagnosis, noting that more than 40 per cent of people living with diabetes do not know they have the condition and therefore remain undiagnosed.

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