Global experts publish landmark update on type 2 diabetes
A group of global experts in type 2 diabetes have come together to deliver an up to date overview of the health condition that affects millions of people around the world in the journal, Nature Reviews Disease Primer in March 2026.
The esteemed journal publishes complete overviews of specific diseases or disorders, covering topics from diagnosis, screening and prevention to management and quality of life.
This paper brings together experts from South Korea, the USA, Brazil, Ghana and Bulgaria, to provide a global perspective, alongside Professor Davies and colleagues from the National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC): Professor Tom Yates, and early-career researchers, Dr Jonathan Goldney and Dr Tommy Slater.
Together they examine the changing global incidence of the disease, the mechanisms of its progression, its diagnosis and treatment, to provide a much needed picture of TD2M in 2026.
The lead author, Professor of Diabetes Medicine at the University of Leicester and Co-Director of the Leicester Diabetes Centre, Melanie Davies, said: “Since the last overview was published, type 2 diabetes (T2DM) has become a global epidemic.”
The authors propose that the epidemic is being caused by individuals’ underlying genetic risk alongside a changing social environment, which is driving sedentary lifestyle, adverse diet and obesity.
Broadly these are driven by the social determinants of health, and include things like public policy, income inequality, food environment, adverse housing quality and social isolation. This paper details these social determinants of health, and their complex interplay with type 2 diabetes.
The review also includes a new way of thinking about the biological changes that cause type 2 diabetes: called the ‘Tumultuous Thirteen’.
Dr Jonathan Goldney from LDC explained: “This new way of thinking highlights how thirteen different systems in the body can malfunction and lead to type 2 diabetes, varying from how the body produces and uses insulin, a core hormone important for lowering blood sugar, to more newly-identified processes including the gut microbiome and appetite hormone signalling.
“This review highlights that these systems are all interrelated, and how they could all be important in developing future treatments for type 2 diabetes.”
The review also includes a critical review of one of the most significant changes in T2DM treatment: the increasing number of ‘GLP-1’ based medications. These medications mimic hormones that help the body feel full and regulate blood sugar which often lead to large amounts of weight loss. The review includes a graphic explaining the current treatment landscape of these medications, and highlights the large number of new medications that are likely to become available over the next 5-years.
You can view this graphic online in the PrimeView article in Nature Reviews Disease Primers.
Professor Davies added: “GLP-1RAs and dual GLP-1–GIP agonists have revolutionised pharmacological management of T2DM by providing benefits beyond glycaemic control, including substantial weight loss and cardiovascular benefits.
“Similarly, SGLT2 inhibitors have become foundational treatments particularly for all individuals with co-existing health conditions.
“However the complex nature of type 2 diabetes and the illnesses that often present with it alongside it underscore the urgent need for a person-centered, holistic approach from health care providers.
“One that integrates glucose and weight management with broader attention to other health conditions, 24-hour physical behaviours, wellbeing and social determinants of health.”
You can read the full article on the Nature Reviews Disease Primers website.
Professor Melanie Davies, LDC Co-Director.
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