Cardivo guides

Diabetes treatment in 2026: what works and what's new

Updated October 30, 2026 · Wellness education, not medical advice

Key takeaways

Type 2: lifestyle plus medicines — metformin, GLP-1 receptor agonists, tirzepatide, SGLT2 inhibitors and others — chosen by heart, kidney and weight needs.
Type 1: insulin is essential; automated insulin delivery (pump + CGM) now adjusts doses automatically.
Teplizumab can delay the onset of stage 3 type 1 diabetes in people at high risk.
In an early trial of stem-cell–derived islets, 10 of 12 people with type 1 diabetes no longer needed insulin after one year.

Treating type 2 diabetes

Lifestyle first — and always

Healthy eating (see the diabetes diet), 150 minutes of activity a week, weight loss when needed, good sleep and not smoking lower glucose and protect the heart. Losing 10–15% of body weight can put type 2 diabetes into remission for some people.

Medicines

Medicine class	Examples	Key points
Metformin	Metformin	Long-used, low cost, low risk of lows
GLP-1 receptor agonists	Semaglutide, dulaglutide, liraglutide	Lower glucose and weight; heart benefits for many
Dual GIP/GLP-1 agonist	Tirzepatide	Large A1C and weight reductions
SGLT2 inhibitors	Empagliflozin, dapagliflozin	Protect heart and kidneys
DPP-4 inhibitors	Sitagliptin, linagliptin	Oral, well tolerated
Sulfonylureas	Glipizide, glimepiride	Inexpensive; can cause low blood sugar
Insulin	Basal and mealtime insulins	When other options aren't enough

Current ADA Standards of Care recommend choosing medicines based on heart disease, kidney disease, heart failure and weight goals — not only A1C. Details in diabetes medications.

Metabolic surgery

For some people with obesity, bariatric surgery leads to large weight loss and often diabetes remission.

Treating type 1 diabetes

Insulin by injection or pump is essential.
Continuous glucose monitors (CGMs) show glucose every few minutes with alerts.
Automated insulin delivery ("closed-loop" or "artificial pancreas") systems link a pump and CGM so insulin adjusts automatically, improving time in range and reducing lows.

What's new in diabetes treatment

Delaying type 1 diabetes: teplizumab (Tzield), approved by the FDA in 2022, can delay the onset of stage 3 type 1 diabetes in people aged 8 and older with early-stage disease.
Islet cell therapy: donislecel (Lantidra), approved in 2023, uses donor pancreatic islets for some adults with hard-to-control type 1 diabetes.
Stem-cell–derived islets: in a trial of zimislecel published in the New England Journal of Medicine in 2025, 10 of 12 participants who received the full dose no longer needed insulin injections after one year. It still requires immune-suppressing medicine and is in larger trials — not yet a cure.
Weekly insulins and oral GLP-1 medicines are in late development or under regulatory review in several countries.

Headlines about a "new diabetes treatment success" usually refer to trials like these. Ask your care team whether any are right for you or whether a clinical trial is an option.

Treatment works best when you can see it

Whatever your plan, tracking shows what's working. Cardivo keeps glucose (including CGM data from Apple Health), blood pressure, heart rate and mood in one journal, with weekly trends and a doctor-ready PDF. Continue with diabetes management and diabetes complications.

This guide is general wellness education based on the public sources below. It is not medical advice, diagnosis, or treatment. Cardivo is not a medical device. If you think you are having a medical emergency, call 911.

Frequently asked questions

What is the first treatment for type 2 diabetes?

Lifestyle changes plus a medicine chosen for your needs. Metformin is still common first, but people with heart or kidney disease are often started on a GLP-1 receptor agonist or SGLT2 inhibitor.

Is there a new cure for type 1 diabetes?

Not yet. Stem-cell–derived islet therapy has freed most participants in an early trial from insulin injections, but it needs immune-suppressing drugs and is still being tested.

Can type 2 diabetes go into remission?

Yes, for some people. Significant weight loss — through diet, medicines or surgery — can bring blood sugar back below the diabetes range without medication.

Sources

Cardivo is an ad-free iPhone app that reads heart rate and HRV from your fingertip on the camera in about 30 seconds — no Apple Watch needed — and keeps blood pressure, blood sugar, and mood in one journal you can share with your doctor as a PDF. Download on the App Store.