On World Diabetes Day 2026, the World Health Organisation released a guideline it had never before issued: a way to diagnose and treat type 1 diabetes in adults, more than a century after insulin was first discovered. Its central counsel is simple and old in substance: those living with the condition, whose bodies make little or no insulin, should receive it through several injections a day, dosed to their blood glucose. The guideline is written less for the well-equipped clinic than for the many places where insulin is scarce, care is fragile, and emergencies have broken ordinary services. It
WHO Issues First Global Guideline on Type 1 Diabetes in Adults, Calling for Multiple Daily Insulin Injections
Many people with type 1 diabetes cannot access affordable, high-quality insulin, and untreated or poorly managed diabetes can lead to blindness, kidney failure, heart attacks, strokes and amputations.
Discovered a century ago, insulin still isn't reaching everyone who needs it
Mark
Why does a first-ever guideline matter when insulin is over a hundred years old?
Mimi
Because the drug existed but adult type 1 care had no single global standard from WHO. Now countries have one reference, including for places with few resources.
Mark
What exactly does it tell doctors to do?
Mimi
Give insulin in multiple daily injections, adjust doses to blood glucose, and monitor regularly. Human insulin is named as an appropriate, effective option.
Luke
Does the guideline say how many people can't get insulin?
Mimi
Not in this reporting. Dr Brostrom says many lack affordable, high-quality insulin, but no figure is given.
Luke
So that's a statement, not a measured number.
Mark
What about monitoring when there's no equipment?
Mimi
Urine glucose testing may be considered where blood testing isn't available. It's an explicit fallback.
Luke
And the 2030 goal? Is anyone funding it?
Mimi
The reporting says WHO will provide implementation tools and guidance on tracking progress. Funding isn't mentioned, so that remains unknown.
Mark
Why stress adults when type 1 is thought of as childhood diabetes?
Mimi
WHO says it increasingly affects adults, so services can't stop at paediatric care.
Luke
Worth noting the 9.5 million and 500,000 figures are WHO estimates, not counts.
The Pulse
- Roughly 9.5 million people lived with type 1 diabetes in 2025, and another 500,000 were newly diagnosed that year, with adults increasingly among them.
- Many patients cannot obtain affordable, high-quality insulin, and without it the consequences can be blindness, kidney failure, heart attacks, strokes and amputations.
- WHO's first-ever adult guideline sets out multiple daily insulin injections, with human insulin named as an effective option, and offers guidance usable even in emergencies and humanitarian crises.
- Monitoring is now central to care, from periodic blood tests at clinics to finger-prick checks and continuous glucose sensors at home, with urine testing as a fallback where blood testing is unavailable.
- The target is set: by 2030, everyone with type 1 diabetes should have affordable insulin and self-monitoring, with WHO supplying tools to track whether countries are getting there.
On World Diabetes Day 2026, the World Health Organisation released a guideline it had never before issued: a way to diagnose and treat type 1 diabetes in adults, more than a century after insulin was first discovered. Its central counsel is simple and old in substance: those living with the condition, whose bodies make little or no insulin, should receive it through several injections a day, dosed to their blood glucose. The guideline is written less for the well-equipped clinic than for the many places where insulin is scarce, care is fragile, and emergencies have broken ordinary services. It reflects a quiet recognition that a discovery of the last century has not yet reached everyone who needs it, and that the condition now claims more adult lives than its childhood reputation once suggested.
On Saturday, World Diabetes Day 2026, the World Health Organisation published its first guideline on diagnosing and managing type 1 diabetes in adults. The condition, in which the pancreas makes little or no insulin, means those who live with it depend on daily insulin to survive, and the guideline arrives more than a century after that medicine was discovered.
The core advice is direct: multiple injections each day, adjusted to blood glucose levels. Human insulin is named as an appropriate and effective choice, with other options used where circumstances require. The document is meant to work far beyond well-funded clinics, in low-resource settings, emergencies and humanitarian crises, where access to affordable insulin and quality care is often lacking.
WHO treats monitoring as central, from periodic lab tests reflecting recent average glucose to finger-prick checks and continuous sensors worn at home. Where blood testing is impossible, urine glucose testing may be considered.
The scale is significant. An estimated 9.5 million people lived with type 1 diabetes in 2025, and 500,000 were newly diagnosed. Long linked with childhood, the condition increasingly affects adults, and WHO urges health systems to build services that reach beyond paediatric care.
Dr Soren Brostrom, WHO's Director of Noncommunicable Diseases and Mental Health, observed that insulin is a lifesaving treatment yet many people still cannot get affordable, high-quality supplies. The guideline aims to help countries improve care even where resources are thin.
It sits within a 2030 goal: universal access to affordable insulin and blood glucose self-monitoring for everyone with type 1 diabetes. WHO will provide implementation tools and progress-tracking guidance, and urges governments to involve people living with the condition in designing and judging programmes.
On Saturday, World Diabetes Day 2026, the World Health Organisation published something it had never produced before: a guideline on how to diagnose and manage type 1 diabetes in adults. It arrives more than a century after insulin was discovered.
The central recommendation is direct. People with type 1 diabetes should receive insulin through multiple injections each day, with doses adjusted according to their blood glucose levels. The guideline names human insulin, a manufactured medicine that works much like the hormone the body makes naturally, as an appropriate and effective option. Other types may be used where needed, depending on a patient's circumstances and what is available.
The document is written to work in many settings, not only well-funded clinics. WHO says it is meant to guide care in low-resource environments, in emergencies and in humanitarian crises, and it calls for better access to affordable insulin, regular glucose monitoring and quality diabetes care, especially in countries and communities with limited health resources.
Monitoring is treated as a core part of treatment. At health facilities, it may mean periodic blood tests that reflect average glucose levels over the previous few months. At home, WHO recommends finger-prick testing or continuous glucose monitors, which use small sensors worn on the skin. Where blood glucose testing cannot be had at all, the guideline says urine glucose testing may be considered instead.
The scale behind the guideline is large. WHO estimates that 9.5 million people were living with type 1 diabetes worldwide in 2025, and that another 500,000 were diagnosed that same year. The condition is a lifelong one in which the pancreas makes little or no insulin, so those who have it depend on daily insulin to survive. Though long associated with childhood, WHO notes it increasingly affects adults, and it urges health systems to build diagnosis and treatment services that extend beyond paediatric care.
Dr Soren Brostrom, WHO's Director of Noncommunicable Diseases and Mental Health, put the problem plainly. Insulin, he said, is a lifesaving treatment discovered more than 100 years ago, yet many people with type 1 diabetes still lack access to affordable, high-quality supplies. He said the guideline offers evidence-based recommendations to help countries improve care, including where resources are thin and health services have been disrupted.
The guideline is tied to a broader target: that by 2030 everyone with type 1 diabetes has access to affordable insulin and to blood glucose self-monitoring. WHO says it will support countries with implementation tools and guidance for tracking progress. It also urges governments to involve people living with type 1 diabetes in designing, running and evaluating diabetes programmes, so that patients' experience shapes policy.
This year's World Diabetes Day theme is "Early action on diabetes," which stresses timely diagnosis, proper treatment and sustained management. The stakes are well documented: diabetes that goes undiagnosed or poorly managed can lead to blindness, kidney failure, heart attacks, strokes and lower-limb amputations.
WHO's wider figures show the size of the challenge. The global burden of diabetes has grown more than fourfold since 1990, and about 830 million people were living with the disease in 2022, most of them with type 2. More than 40 per cent of people with diabetes do not know they have it. The 2030 target is now the benchmark against which countries will be measured.
Notable Quotes
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.— Dr Soren Brostrom, WHO Director of Noncommunicable Diseases and Mental Health
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