EASD Congress in Milan: Shift Toward Comprehensive Organ Protection in Diabetes

Milan gathered over 15,000 participants for the European Association for the Study of Diabetes congress, marking the first time the event returned to Italy in eighteen years. The scientific consensus emerging from the gathering established that diabetes care must transition from simply monitoring blood sugar to providing early, comprehensive organ protection.

• Diabetes management now prioritizes early, global protection for the heart, kidneys, and liver rather than focusing exclusively on blood glucose levels.
• GLP-1 receptor agonists, dual agonists, and SGLT2 inhibitors are recommended as first-line therapies starting from the moment of diagnosis.

The Shift From Glucose Control to Organ Protection in Milan

The primary clinical problem highlighted at the congress involves the rising prevalence of diabetes across Europe, projected to reach 12.2 million people by 2050, representing a veritable pandemic that will become increasingly costly for health systems to manage. In response to this expanding health crisis, clinical guidelines now position GLP-1 receptor agonists, dual agonists, and SGLT2 inhibitors as first-line recommendations to be initiated at diagnosis. These treatments are employed even in substitution or early accompaniment to metformin, supported by findings from studies such as SMARTEST regarding early intervention in type 2 diabetes. The 2026 update to the joint EASL-EASD-EASO guidelines on MASLD integrates previous recommendations to account for the first targeted therapies for metabolic dysfunction-associated steatohepatitis.

Obesity Treatment Reduces Societal Costs and Sick Leave

Doustdar argued that failing to treat chronic obesity drives up societal costs through connected complications like type 2 diabetes and cardiovascular disease, noting that semaglutide usage reduces sick leave by five days annually. Meanwhile, public outreach efforts led by Lilly during the Milan congress featured interactive installations and historical exhibitions highlighting a century and a half of pharmaceutical development in metabolic health. Elias Khalil, President and Managing Director of the Italy Hub at Lilly, detailed the company’s initiatives, noting that Lilly was founded in 1876 in Indianapolis by Eli Lilly, a pharmacist and veteran of the American Civil War who sought to produce reliable, science-based medicines after witnessing wartime devastation. Less than fifty years later, Lilly became the first company to manufacture insulin on an industrial scale, and today the global enterprise employs approximately 50,000 people across core areas including diabetes and obesity, neuroscience, immunology, and oncology. Public engagement during the congress also featured the Fuori Congresso Connecting to Cardiometabolic Health in Piazza Tre Torri, featuring interactive spaces designed by artist and designer Marco Oggian, alongside a historic tram carrying visitors through the city center, and nightly red illuminations of the Centrale station throughout the entire week.

New Therapies Delay Diabetes Onset and Improve Weight Reduction

Research presented at the Milan conference explored multi-target receptor agonists designed for enhanced weight reduction and metabolic control, alongside amylin agonists. Immunomodulating therapies, specifically anti-CD3 monoclonal antibodies administered in the preclinial phase, delay the clinical onset of diabetes by approximately two years by interrupting autoimmune destruction of pancreatic beta cells before marked hyperglycemia appears. Real-world registry data from Germany, Austria, and Luxembourg indicated that GLP-1 and dual GIP/GLP-1 usage among pediatric and young adult patients aged 6 to 24 grew from 6.3 percent in 2019 to 27.2 percent in 2025.

Unresolved Real-World Access and Long-Term Sustainability

Disclaimer: The information provided in this article is for educational and scientific communication purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider regarding any medical condition, diagnosis, or treatment plan.