Diabetes Care (ADA) 'Under Review': What Each Status Means

Before the paper reaches Associate Editor assignment, the Diabetes Care Editor-in-Chief assesses each submission via the priority-score gate. ADA does not publish a desk-rejection rate. A desk rejection can mean the EIC concluded that the work would fit better at a sister ADA journal (Diabetes for basic-translational diabetes, Clinical Diabetes for primary-care diabetes, Diabetes Spectrum for diabetes education) or that the clinical diabetes priority bar is not met.

ADA returns manuscripts that do not meet its stated requirements to the authors as incomplete. Those requirements include the main document in Word format, the CONSORT checklist for randomized trials, the STROBE or PRISMA checklist where applicable, conflict-of-interest statements, ethics review board approval, trial-registration details, and the manuscript submission form. A data and resource availability statement is encouraged rather than required.

The EIC assesses each submission to determine whether the content meets Diabetes Care's clinical diabetes priority threshold. The priority-score gate filters out manuscripts below the 50th percentile.

ADA's peer-review policy says the Editor-in-Chief may consult other Editorial Board members if there is significant divergence of opinion among the Associate Editors and the peer reviewers on how a manuscript should be decided.

Papers that pass the priority-score threshold are assigned to an Associate Editor versed in the subject area of the manuscript. The Associate Editor invites expert researchers to peer review the manuscript.

Diabetes Care Associate Editors choose reviewers as experts in the manuscript's area, and the recommendation rests on the reviews of three peer reviewers. ADA publishes no recruitment timeline.

ADA publishes no peer-review duration. Reviewers are asked for written, objective assessments of the strengths and weaknesses of the manuscript, including study design and methodology, the quality and interpretation of the data, and any ethical concerns, and the Associate Editors rate the quality and timeliness of each review.

After reports return, the Associate Editor synthesizes them and recommends a decision to the EIC (accept, reject, or revise and resubmit), and the EIC conveys the final decision. Revisions often request additional outcome data or disparities analysis. Accepted articles are published online ahead of print 5 to 6 weeks after acceptance.

• A quick return: the journal's average time to first decision is 18 days, so an early return is most likely an EIC priority-score decision or desk rejection.

• Still Under Review well past the 18-day average: A likely signal that the paper met the priority-score threshold and is in external review, since only manuscripts above the 50th percentile are reviewed.

• Still Under Review for months: Reviewer-recruitment or reviewer-report delay is possible. ADA publishes no maximum, so a polite inquiry via the ScholarOne portal is appropriate.

• Status changes to "Decision Pending": Reports are in; ADA publishes no decision timeline.

This is the most common anxiety we hear from Diabetes Care authors during the active editorial window. The honest answer: not necessarily, but 10 weeks is well past the journal's 18-day average time to first decision, and ADA publishes no timing for papers in external review. Reports may still be arriving with the Associate Editor preparing for editorial synthesis.

If the portal still says Under Review after several more weeks, one of the assigned reviewers may be late and the Associate Editor may be waiting on a report or a replacement. ADA publishes no deadline, so a polite inquiry through ScholarOne is appropriate.

The Instructions for Authors direct questions about any part of the peer-review process to the Diabetes Care Editorial Office, so a single polite inquiry with your manuscript ID is acceptable once the wait is clearly beyond the journal's average. Repeated messages are unlikely to speed anything up.

If your Diabetes Care paper is rejected after review, the natural cascade depends on what the reviewers and Associate Editor cited:

Diabetes is the natural ADA cascade for basic-translational diabetes papers where the clinical-application bar of Diabetes Care is not the primary contribution. Diabetes uses ScholarOne at ScholarOne submission portal; editorial contact diabetes@diabetesjournals.org.

Clinical Diabetes is the ADA cascade for primary-care diabetes practice papers.

Diabetes Spectrum is the ADA cascade for diabetes education and management papers.

Diabetes, Obesity, and Cardiometabolic CARE is the new ADA cascade for cardiometabolic-care focused papers.

Diabetologia is the external EASD cascade for European clinical diabetes research.

Journal of Diabetes (Wiley) is the external cascade for general clinical diabetes. Wiley uses Editorial Manager at Editorial Manager submission portal; editorial contact jdiabetes@wiley.com.

The Lancet Diabetes & Endocrinology is the Lancet specialty cascade for top global-impact diabetes/endocrinology. The Lancet uses Editorial Manager at Editorial Manager submission portal; editorial contact editorial@lancet.com.

ADA's peer-review policy lists the elements of a high-quality review, adopted from WAME. The table below maps them to actionable preparation.

Across Diabetes Care-targeted manuscripts, and across Manusights review data from 50+ diabetes, endocrinology, and clinical-medicine manuscripts, three named patterns generate the most consistent reviewer concerns and the most common reasons papers miss the editorial bar or fail the priority-score gate.

Below-50th-percentile clinical priority framing flagged at EIC. When the introduction frames the work too narrowly without broader clinical diabetes priority, EIC priority-score return is common. The strongest Diabetes Care manuscripts make the clinical question visible in the title, abstract, first table, and final introduction paragraph, then connect the cohort, endpoint, and practice implication to the ADA readership rather than relying on a generic "important disease burden" rationale.

Disparities analysis gaps surface as reviewer concerns. When the manuscript does not include disparities analysis in the main outcomes, Diabetes Care reviewers consistently ask for race, ethnicity, socioeconomic status, geography, access, or cost-effectiveness context. The strongest manuscripts do not bury these variables in supplemental tables. They explain missingness, subgroup power, and what can or cannot be inferred from the enrolled population.

ADA family cascade offers from Associate Editor. When the Associate Editor concludes the work is rigorous but the clinical diabetes priority bar of Diabetes Care is not met, transfer offers to Diabetes for basic-translational work, Clinical Diabetes for primary-care practice, or Diabetes Spectrum for education and management are common. Authors should prepare the cover letter and response plan so the manuscript can move cleanly if the reviewer concerns point to a better ADA family fit.

Source limitation: this guidance combines official guidance, public status and timing signals, and anonymized Manusights pre-submission review patterns; it does not use private ADA editorial records. Compared with official guidance, the useful reader-facing value is translating the status into clinical-priority, outcomes-table, statistics, disparities, and ADA routing checks authors can act on while waiting.

This page was created from ADA's public Diabetes Care instructions for authors at Diabetesjournals author instructions, ADA Journal Policies documentation and the journal's About the Journal page (EIC priority-score gate above the 50th percentile, an 11.06% acceptance rate, an 18-day average time to first decision, three peer reviewers, publication online ahead of print 5 to 6 weeks after acceptance), and Manusights pre-submission review experience with Diabetes Care-targeted manuscripts.

For the ADA diabetes landscape beyond Diabetes Care, start with the Diabetes Care journal overview, the Diabetes Care submission guide, the Diabetes Care review-time guide, and the Diabetes Care cover-letter guide.

Then compare Diabetes (basic-translational diabetes), Clinical Diabetes (primary-care), Diabetes Spectrum (education), Diabetes, Obesity, and Cardiometabolic CARE (cardiometabolic), and external diabetes alternatives (Diabetologia, Journal of Diabetes, Lancet Diabetes & Endocrinology).

The choice across these titles depends on whether the central contribution is top ADA clinical diabetes (Diabetes Care), basic-translational diabetes (Diabetes), primary-care diabetes (Clinical Diabetes), diabetes education (Diabetes Spectrum), cardiometabolic care (Diabetes, Obesity, and Cardiometabolic CARE), European clinical diabetes (Diabetologia), general diabetes research (Journal of Diabetes), or top global-impact (Lancet Diabetes & Endocrinology).

Reviewers at Diabetes Care are experts chosen by the Associate Editors, and the recommendation rests on three peer reviewers. Editors screen and triage manuscripts before any external reviewer sees them via the priority-score gate, and preparing a response template that addresses both clinical-significance and disparities-analysis perspectives accelerates revision rounds substantially.

For a pre-upload check of your manuscript against the Diabetes Care clinical-diabetes-priority-plus-disparities bar before submission, our Diabetes Care pre-submission diagnostic flags the framing and disparities-analysis weaknesses most likely to surface in reviewer reports.

Already submitted? The Diabetologia Under Review status guide explains what the current status means and when a follow-up is appropriate.