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Article History

Received: 9 October 2025

Accepted: 24 March 2026

First Online: 11 September 2026

Ethics

Data availability: The extracted data and other materials underlying the results reported in this article are available from the EASD (info@easd.org) upon reasonable request to researchers who provide a methodologically sound proposal and for the duration of the approved project. The shared materials include the published aggregate study-level data extracted for the meta-analyses; no individual participant-level data are available. Shared materials may not be used for purposes that are inconsistent with the approved proposal or otherwise misrepresent the findings of the review.

Funding: The EASD provided financial support to enable SBJS, SR and FR, who were part of the Evidence Synthesis Team, to work on the protocol and the systematic review. The protocol and manuscript were developed independently but approved by the EASD. The EASD did not contribute to the development of the protocol or to the manuscript. The two methodologists in the Guideline Development Panel (TK and FZ) as well as the two panel members with lived experience (ML and WJ) received financial reimbursement from the EASD for their contribution to development of the guideline. The remaining members of the Guideline Development Panel did not receive financial reimbursement by the EASD.

Authors’ relationships and activities: FR is a member of the editorial board of Diabetologia . RIGH has received honoraria for speaker engagements from Boehringer Ingelheim, Eli Lilly, Encore, Liberum, Novo Nordisk and ROVI Pharma and consultancy fees from SPOTLIGHT-AQ unrelated to this work. The other authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.

Contribution statement: The EASD Guideline Oversight Committee conceived the idea for the topic as an EASD guideline, which was operationalised by the Guideline Development Panel. The Guideline Development Panel (TK, FZ, WJ, NH, KK, ML, AM, JSp, JSt, RH) developed the concept and design of the systematic review, which was performed by the Evidence Synthesis Team (SS, SR, MB, ND, LS, ML, PE, JB, FR). SS and FR contributed to acquiring trial reports, trial selection, data extraction, data analysis, data interpretation and technical report drafting. TK, FZ and SR contributed to trial selection, data analysis, data interpretation and technical report drafting. MB contributed to trial selection, data extraction and technical report drafting. ND contributed to acquiring trial reports, data extraction and technical report drafting. LS contributed to search strategy development and technical report drafting. ML and PE contributed to data interpretation and technical report drafting. MJ contributed to data extraction and technical report drafting. WJ and ML contributed to drafting and critically revising the technical report and interpretation of the data. NH, JSt, JSp, AM, RH and KK contributed to trial selection, data interpretation and technical report drafting. TM and MW contributed to data interpretation and technical report drafting. JB contributed to data analysis, data interpretation and technical report drafting. All authors approved the final version of the manuscript. FR is the guarantor of this work.