8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes—2022
Open accessAbstract
The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Weight loss medications are effective adjuncts to lifestyle interventions and healthy behaviors for management of weight in people with diabetes.
“Weight loss medications are effective adjuncts to lifestyle interventions and healthy behaviors for management of weight and have also been found to improve glucose control in people with diabetes (127).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [127]
The Recommendations (p. 4) say weight-loss medications are effective adjuncts to diet, physical activity, and behavioral counseling for selected people with type 2 diabetes and BMI ≥27 kg/m². Approved Weight Loss Medications (p. 4) says nearly all approved medications improve glycemic control in patients with type 2 diabetes. The citing sentence broadens these findings to people with diabetes generally; the paper notes that trial data for type 1 diabetes are limited. (LLM, conf=0.88)
Experimental — accuracy not yet measuredWeight loss medications improve glucose control in people with diabetes.
“Weight loss medications are effective adjuncts to lifestyle interventions and healthy behaviors for management of weight and have also been found to improve glucose control in people with diabetes (127).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [127]
The Approved Weight Loss Medications section (p. 4) says nearly all FDA-approved weight loss medications improve glycemic control in patients with type 2 diabetes and are used as adjuncts to diet, exercise, and behavioral therapy. The citing sentence broadens this to people with diabetes generally; the same section (p. 4) notes that trial data for people with type 1 diabetes are limited. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEvidence-based obesity treatment includes interventions addressing 5 major categories: behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic/bariatric procedures.
“Evidence-based obesity treatment includes interventions addressing 5 major categories: behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic/bariatric procedures.”
From Obesity Management in Adults (2023) · cites this paper as [11]
Recommendations (p. 2) cover diet, physical activity, and behavioral therapy; Recommendations (p. 4) address weight-loss medications, and the paper discusses metabolic surgery. Together these support the listed approaches, but the paper frames its guidance as obesity management for adults with type 2 diabetes (p. 1), not obesity treatment generally, and does not designate them as five major categories. (LLM, conf=0.84)
Experimental — accuracy not yet measuredModerate- to high-intensity behavioral programs include 12 or more sessions in the first year (ideally ≥14 sessions in 6 months), followed by a maintenance phase for up to 24 months.
“Moderate- to high-intensity programs include 12 or more sessions in the first year (ideally ≥14 sessions in 6 months), followed by a maintenance phase for up to 24 months.5,11,13”
From Obesity Management in Adults (2023) · cites this paper as [11]
The Behavioral Interventions section (p. 3) supports frequent initial sessions followed by long-term maintenance. But it specifies at least 16 sessions in the first 6 months, not a threshold of 12 in the first year or an ideal of 14 in 6 months. The Recommendations (p. 2) call for maintenance lasting at least one year; they do not set an upper limit of 24 months. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAmong Asian populations, cardiometabolic diseases occur at lower BMI levels; therefore, some expert guidelines recommend lower BMI thresholds (BMI ≥25 and ≥27.5 for obesity).
“Among Asian populations, cardiometabolic diseases occur at lower BMI levels; therefore, some expert guidelines recommend lower BMI thresholds (guidelines differ in thresholds of BMI ≥25 and ≥27.5 for obesity).4,9,11”
From Obesity Management in Adults (2023) · cites this paper as [11]
The Recommendations (p. 2) say BMI cut points are lower for Asian and Asian American populations because of differences in body composition and cardiometabolic risk. Table 8.1 (p. 3) gives Asian-specific BMI ranges beginning at 25.0 and 27.5, but it presents these as treatment categories, not as two differing guidelines’ thresholds for defining obesity. The source therefore supports the rationale and lower cut points, but not the precise characterization of both numbers as obesity thresholds. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Clinicians can offer multiple effective obesity treatments.
“clinicians can offer multiple effective obesity treatments.9–11”
From Obesity Management in Adults (2023) · cites this paper as [11]
Guidelines recommend lifestyle interventions, glucose-lowering agents, and RAS/SGLT2 inhibitors for type 2 diabetes patients to slow kidney function loss and reduce CVD events.
“Clinical practice guidelines for patients with type 2 diabetes recommend lifestyle interventions, including increased physical activity and weight loss, glucose-lowering agents to optimize glycemic control, and pharmacological treatment with renin–angiotensin system (RAS) inhibitors and sodium–glucose cotransporter 2 (SGLT2) inhibitors to slow progression of kidney function loss and reduce the inc”
SGLT2 inhibitors are guideline-recommended therapies for kidney protection in people with type 2 diabetes, and guidelines suggest semaglutide can be prescribed as an adjunct to RAS inhibitors and SGLT2 inhibitors to further reduce albuminuria.
“This is clinically relevant since SGLT2 inhibitors are now guideline-recommended therapies for kidney protection in people with type 2 diabetes, and guidelines suggest that semaglutide can be prescribed as an adjunct to RAS inhibitors and SGLT2 inhibitors to further reduce albuminuria (1,2).”
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References 131 · Cited by 244
Research works printed but not linked: 12
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- Authors
- American Diabetes Association Professional Practice Committee
- Corresponding author
- American Diabetes Association Professional Practice Committee
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2021-12-16
- Volume
- 45
- Issue
- Supplement_1
- Pages
- S113-S124
- ISSN
- 0149-5992 (ISSN-L)
- OpenAlex
- W4200060784
- Cited by
- 244
- References
- 131
- Citations by year
- 2026: 10 · 2025: 35 · 2024: 48 · 2023: 81 · 2022: 69
- FWCI
- 7.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- obesity, weight management, type 2 diabetes, diabetes prevention, diabetes treatment, clinical guidelines
- MeSH terms
- Diabetes Mellitus, Diabetes Mellitus, Type 2, Endocrinology, Humans, Obesity, Reference Standards, Societies, Medical, Standard of Care
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