Diabetes changes are coming
Aotearoa New Zealand is changing its diagnostic threshold for diabetes from 1 July 2026 to align with WHO guidance and international definitions. This is expected to move a small number of people currently classified as having prediabetes into the diabetes category. Across the Pinnacle network, this could affect approximately 295 people. We wanted to give practices early notice and share some initial guidance, including FAQs. Te Whatu Ora Health NZ is expected to issue a national announcement ahead of 1 July, along with supporting resources, which we will share as they become available.
Effective 1 July 2026 the national diagnostic thresholds for HbA1c are changing to:
- Diabetes: HbA1c ≥ 48 mmol/mol (lowered from the current ≥ 50 mmol/mol).
- Prediabetes: HbA1c 42 – 47 mmol/mol (previously 41 – 49 mmol/mol)
- Normal: HbA1c < 42 mmol/mol.
- No confirmatory test required if HbA1c > 53 mmol/mol.
What is changing
Aotearoa New Zealand is changing its diagnostic threshold for diabetes to align with WHO guidance and international definitions. As a result, some people who have previously been classified as having prediabetes will now meet the criteria for diabetes.
This means an estimated 34,500 people nationally who were previously diagnosed with prediabetes may now fall into the diabetes category. That is around 3.45 per cent of those currently classified as prediabetic.
Across the Pinnacle network, practices currently care for 8,570 people with prediabetes. Based on the national estimate, this could equate to approximately 295 additional people across our 89 practices.
What this means in practice
More information is expected, but we wanted to give practices early notice as this information is already circulating and teams may want to begin considering the implications locally.
It is worth keeping in mind that diabetes exists on a spectrum. Microvascular risk begins to increase above an HbA1c of 39 mmol/mol, which is the threshold used for prediabetes in some countries. At the borderline range, diabetes is not usually symptomatic.
We will work through the implications for dashboards and related tools over the coming weeks. At this stage, we do not expect this change to have a substantial funding impact.
Talking with patients
Some patients may understandably have questions or concerns about the change in diagnosis.
We expect national guidance will include suggested “scripts” to help explain the change to patients. In the meantime, a simple explanation may be along the lines of:
“New Zealand has been out of step with some other countries for a number of years. From 1 July 2026 (indicated), the diagnostic criteria have changed. Your HbA1c result has not changed, and your risk of complications has not suddenly changed either, but the label in your notes may now change from prediabetes to diabetes. We will review this with you and manage it in line with current guidance.”
Frequently asked questions
We then need to treat according to the current guidance. We have spoken to representatives from the advisory group and our clinical team will add to these Frequently Asked Questions as more information comes to hand.
Summary
Aotearoa New Zealand is changing its diagnostic threshold for diabetes from 1 July to align with WHO guidance and international definitions. This is expected to move a small number of people currently classified as having prediabetes into the diabetes category. Across the Pinnacle network, this could affect approximately 295 people. Further guidance is expected from Te Whatu Ora Health NZ along with official resources, but we wanted to give practices early notice and share some initial advice.
For more information
Clinical Director