A new clinical practice guideline has emerged, placing lifestyle interventions at the core of type 2 diabetes and prediabetes care, marking a significant shift in the approach to managing these prevalent conditions.
The American College of Lifestyle Medicine (ACLM) published the guideline titled “Lifestyle Interventions for Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults” in the American Journal of Lifestyle Medicine. This guideline offers a comprehensive, evidence – based roadmap for clinicians. Unlike many existing diabetes guidelines that merely mention lifestyle as part of care without specifics, it effectively incorporates therapeutic lifestyle behavior interventions as a mainstay of treatment.
This new guideline addresses a critical public health issue. Over half of U.S. adults have diabetes or prediabetes, resulting in billions of dollars in annual healthcare costs. It provides clear, actionable recommendations for lifestyle changes. Strategies include assessing baseline lifestyle habits, gauging readiness to change, and offering health coaching. Additionally, it presents a framework for reducing medication use following successful lifestyle interventions.
The guideline comes with over 25 original informational handouts and resources. These tools are designed to help healthcare providers and patients integrate lifestyle medicine into type 2 diabetes care. Its ultimate goal is to empower clinicians and individuals, enabling them to manage type 2 diabetes glycemic levels effectively and prevent the progression from prediabetes or gestational diabetes to actual type 2 diabetes.
“Many clinical practice guidelines recognize the importance of lifestyle factors as a first – line treatment but fail to provide clinicians with practical tools for prescribing sustainable lifestyle changes,” said endocrinologist and guideline author Mahima Gulati, MD, DipABLM, FACLM. “This new guideline is the first to offer detailed lifestyle change strategies with the clinical aim of achieving remission for prediabetes and type 2 diabetes. These strategies not only support this unique guideline but also complement other existing chronic disease guidelines that recommend lifestyle behavior changes.”
The guideline has received endorsements from numerous prominent organizations, including the American Association of Clinical Endocrinology, Obesity Medicine Association, American Academy of Physician Associates, and many others. It has also been recognized with an “Affirmation of Value” from the American Academy of Family Physicians and is supported by the Academy of Nutrition and Dietetics.
A growing body of research has demonstrated the power of lifestyle changes in delaying or preventing type 2 diabetes and, in some cases, achieving remission and reducing or eliminating the need for medications. However, lifestyle behavior interventions have been underutilized, and no previous clinical practice guidelines have explicitly focused on them as essential treatments for type 2 diabetes and prediabetes. Moreover, the ACLM guideline is the first to tailor nutrition recommendations to the specific goals of individuals with or at risk of type 2 diabetes, such as remission, management, or prevention.
The new guideline emphasizes the six pillars of lifestyle medicine: plant – predominant nutrition, physical activity, restorative sleep, stress management, connectedness, and avoidance of risky substances. These pillars form the foundation of treatment and remission strategies. The guideline was developed through collaborative input from a broad coalition of experts from various fields, including primary care, endocrinology, cardiology, and more.
It’s important to note that the ACLM’s guideline is not intended to replace existing diabetes management strategies. Instead, it complements them by providing an evidence – based blueprint for implementing lifestyle interventions effectively. The guideline and its accompanying plain – language summary offer a practical and sustainable framework for both patients and clinicians to assess, prescribe, and implement lifestyle changes.
With type 2 diabetes being considered the defining disease of the 21st century, affecting over 38 million people in the U.S. and with an additional 97.6 million at risk due to prediabetes, and with global costs expected to soar to $1.5 trillion annually by 2050, this new guideline comes at a crucial time. It builds on the ACLM’s previous work, such as the 2022 expert consensus statement and the “Type 2 Diabetes Bill of Rights,” further strengthening the role of lifestyle interventions in the fight against diabetes.
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