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German Diabetes Association : Clinical Practice Guidelines This is a translation of the DDG clinical practice guideline published in Diabetol Stoffwechs 2025; 20: S127–S143. doi: 10.1055/a-2566-7533 Notice of update The DDG clinical practice guidelines are updated regularly during the second half of the calendar year. Please ensure that you read and cite the respective current version. Updates to content and different recommendations compared to the previous year’s version Change 1: In this version of the clinical practice guideline, a number of aspects have been adapted to the current state of science, and corresponding literature has been cited. Reason: The detailed progress in classification and diagnostics makes the update useful. Change 2: New data demonstrate stability of HbA 1c ex-vivo Reason: HbA 1c is an important parameter in the diagnostics and in the course of therapy. Therefore, the statement on the stability of HbA 1c in pre-analytics is important. Change 3: Information on the standardisation of C-peptide measurement. Reason: Standardisation of C-peptide as an essential parameter to quantify insulin secretion and insulin resistance is necessary. Change 4: Pre-diabetes section has been expanded Reason: The stage of pre-diabetes is already associated with a variety of diabetes-related cardiovascular, renal and neurological complications. Change 5: Potential relevance of 1-h plasma glucose value in the oGTT for screening and diagnosis of diabetes Reason: There are new data that suggest a prognostic significance of the 1-h glucose value in the oGTT and offer advantages in diagnostics for practical reasons. Change 6: Importance of screening for type 1 diabetes Reason: Type 1 diabetes is too rarely diagnosed in adults with diabetes. This has relevant therapeutic consequences. Change 7: Section on post-transplant diabetes (PTDM) Reason: With the increasing number of people having received organ transplants, it is not seldom that they develop a diabetes with appropriate therapeutic consequences. Change 8: Outlook: Subtyping of type 1 and type 2 diabetes and obesity Reason: Subtyping diabetes enables more personalised diabetes therapy. Change 9: Possible significance of CGM for screening and diagnosis of (pre-)diabetes Reason: CGM plays an increasing role not only in people with type 1 diabetes, but also in type 2 diabetes. CGM data in everyday life better reflects the regulation of glucose metabolism and is likely more suitable for the diagnosis on hyperglycaemia in the future. Publication History Received: 26 June 2025 Accepted: 09 October 2025 Article published online: 22 April 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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Landgraf et al. (2026) studied this question.
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