Skill Checkup: A 53-Year-Old Woman Recently Diagnosed With Type 2 Diabetes

Anne L. Peters, MD


December 21, 2022

A combination of lifestyle modifications and medications is the ideal approach to achieving and maintaining glycemic control in patients with type 2 diabetes. According to guidelines from the American Diabetes Association (ADA), crucial components of diabetes management include:

According to the 2022 ADA Standards of Care, developing positive health behaviors and maintaining psychological health are the cornerstones for achieving diabetes treatment goals. Patients should be referred for diabetes self-management education and support, medical nutrition therapy, and evaluation of psychosocial/emotional health concerns if indicated. Preventive care services (eg, immunizations, cancer screening, etc.); smoking cessation counseling; and ophthalmologic, dental, and podiatric referrals, as needed, are encouraged for all patients. Behavioral lifestyle interventions should include at least 16 sessions in 6 months and focus on dietary changes, physical activity, and other strategies to achieve an approximate energy deficit of 500-700 kcal per day. Evaluating an individual's medical status, motivation level, life circumstances, and willingness to implement lifestyle changes to achieve weight loss is an essential consideration when weight loss interventions are recommended and initiated.

In addition to diet and lifestyle modifications, early initiation of pharmacologic therapy is associated with improved glycemic control and reduced long-term complications in type 2 diabetes. ADA guidelines recommend that clinicians consider the medication's effect on weight when choosing glucose-lowering medications for patients with type 2 diabetes who are overweight or obese.


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