197 - Sweet Deal of Updates in Diabetes Pharmacotherapy from the ADA 2026 Standards of Care
HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast
Sean P. Kane, PharmD, BCPS
4.9 • 650 Ratings
🗓️ 3 April 2026
⏱️ 49 minutes
🧾️ Download transcript
Summary
In this episode, we discuss the most important annual updates in the American Diabetes Association Guidelines, Standards of Care 2026, particularly focusing on changes in pharmacotherapy recommendations and the supporting evidence.
Key Concepts
- A few existing agents now have ASCVD risk reduction data in patients with existing ASCVD or high indicators for ASCVD. They are: oral semaglutide and tirzepatide.
- SGLT2is are still first-line in patients with diabetes and HF including HFpEF, but SC semaglutide and tirzepatide are now recommended for those with symptomatic HFpEF and obesity due to positive outcomes in this population.
- The GLP-1RA and dual GLP-1/GIP RA are the preferred agents for weight management in patients with T2DM, but use of GLP-1RA can be considered for weight loss in patients with T1DM.
- The guideline also better defines recommendations for medication-induced hyperglycemia from immune checkpoint inhibitors, PI3Kɑ (phosphoinositidylinositol 3-kinase α) inhibitors, mTOR inhibitors, and steroids.
References
- American Diabetes Association. Standards of care in diabetes—2026. Diabetes Care. 2026;49(suppl 1):S1-S377.
- SOUL study. Darren K. McGuire, Marx N, Mulvagh SL, et al. Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes. N Engl J Med. 2025;392(20):2001-2012. doi:10.1056/NEJMoa2501006.
- SURPASS-CVOT. Nicholls SJ, Pavo I, Bhatt DL, et al. Cardiovascular outcomes with tirzepatide versus dulaglutide in type 2 diabetes. N Engl J Med. 2025;393(24):2409-2420. doi:10.1056/NEJMoa2505928.
- SUMMIT. Packer M, Zile MR, Kramer CM, et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med. 2025;392(5):427-437. doi:10.1056/NEJMoa2410027.
- STEP-HFpEF. Kosiborod MN, Abildstrom SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389(12):1069-1084. doi:10.1056/NEJMoa2306963.
- STEP-HFpEF DM. Kosiborod MN, Petrie MC, Borlaug BA, et al. Semaglutide in patients with obesity‑related heart failure and type 2 diabetes. N Engl J Med. 2024;390(15):1394‑1407. doi:10.1056/NEJMoa2313917.
Transcript
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| 0:00.0 | Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions. |
| 0:11.1 | This podcast is provided by pharmacists and faculty members at Rosalne Franklin University College of Pharmacy. |
| 0:17.4 | This podcast contains general information for educational purposes only. This is not professional |
| 0:22.4 | advice and should not be used in lieu of obtaining advice from a qualified health care provider. |
| 0:27.2 | And now on to the show. |
| 0:31.1 | Welcome to Helix Talk, episode 1097. I'm your co-host, Dr. Kane. And I'm Dr. Patel. And the title of today's episode is |
| 0:39.2 | Sweet Deal of Updates in Diabetes Pharmacotherapy from the ADA, American Diabetes Association's |
| 0:45.7 | 2026 Standards of Care. So Dr. Kane in this episode, we're going to discuss some of the important |
| 0:51.9 | annual updates. As we know, American Diabetes Association puts out their guidelines every year. So we're going to discuss some of the important annual updates. As we know, American Diabetes Association puts out their guidelines every year. So we're focusing on the 2026, but particularly |
| 1:00.5 | focusing on some of the pharmacotherapy recommendation changes and supporting evidence. So we're |
| 1:05.5 | going to kind of dive deeper into it. And Dr. Mattel, again, whenever we do this episode, kudos to the ADA for like every year |
| 1:13.7 | busting out a new set of guideline recommendations. I'm sure this is a massive amount of work to do that. |
| 1:19.3 | There's always a lot of new evidence in the diabetes space. So it's really nice that they do this and |
| 1:24.6 | even nicer that they do it every single year. Yeah, I think the last time |
| 1:28.1 | we kind of did a comprehensive sweeping updates from the standards of care was in 2023. That was our |
| 1:34.1 | episode 164. So we have skipped a couple of years. They're not new agents approved in the market, |
| 1:41.2 | but there's some just evidence that's become available. And then that's |
| 1:45.4 | how, you know, these guidelines are incorporating them and weaving them into their recommendations. |
| 1:51.0 | So Dr. Patel, I know digital health is a very hot topic in pharmacy education. And I know that there's |
| 1:56.4 | some new diabetes technology updates that the new guidelines talk about. Why don't we start there? |
| 2:02.6 | Yeah, absolutely. CGMs and automated insulin deliveries. |
| 2:04.6 | That's like the technology that we are talking about today. |
... |
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