Diabetes Guidelines are Plentiful. The New One from the ACLM Can Support Them All

"There are dozens, if not hundreds, of diabetes guidelines out there. We're not looking to reinvent the wheel."

Richard, Rosenfeld, MD, MPH, MBA, was referring to a new clinical guideline from the American College of Lifestyle Medicine (ACLM), titled Lifestyle Interventions for Treatment and Remission of Type 2 Diabetes and Prediabetes in Adults: A Clinical Practice Guideline From the American College of Lifestyle Medicine. The guideline, for which Rosenberg was the lead author, is not unique in its recommendations for changes in eating patterns and physical activity in an overall therapeutic plan for individuals with prediabetes or type 2 diabetes (T2D). However, as he points out, existing guidelines for the treatment of the disease "emphasize the importance of these typically as adjuncts to the rest of the recommendations, which often relate to medication and glucose monitoring and other things. So, they're what you might call the supporting actor, not the lead actor in the approach."

The ACLM guideline is distinguished by its primary focus, which is on not just modifying diet and adding exercise to daily antihyperglycemic medications, but on a wholistic shift that addresses the 6 pillars of lifestyle medicine: Nutrition, physical activity, stress management, sleep, social connections, and avoidance of "risky" substances. Rosenfeld and guideline coauthors accompany the pillars with concise recommendations on how to operationalize the changes. "We've put it all in a single package, and made it doable," he told Patient Care^© in a recent interview. Rosenfeld reiterates that the ACLM recommendations are not meant to replace any existing clinical guidelines but instead can be used to expand or augment them. He explains further in the short video above.

For an at-a-glance preview of the 14 lifestyle interventions recommended in the guideline, see Guideline Topline: 14 Key Lifestyle Interventions to Treat, Prevent Type 2 Diabetes.

Richard Rosenfeld, MD, MPH, MBA, is the distinguished professor of otolaryngology, SUNY Downstate Health Sciences University and senior advisor for quality and guidelines for the American Academy of Otolaryngology – Head and Neck Surgery. Rosenfeld is board certified in otolaryngology – head and neck surgery and in lifestyle medicine.