Guideline Topline: 14 Key Lifestyle Interventions to Treat, Prevent Type 2 Diabetes
These 14 recommendations from the American College of Lifestyle Medicine comprise the core of the first-ever guideline centered on lifestyle change as a first-line intervention.
The American College of Lifestyle Medicine (ACLM) has released a clinical practice guideline that, for the first time, places lifestyle modification at the center of care for adults with type 2 diabetes (T2D) and prediabetes.1,2
Appearing in the American Journal of Lifestyle Medicine,¹ the guideline offers clinicians a structured, evidence-based framework for integrating lifestyle-based treatment into routine diabetes management. Unlike prior guidelines that acknowledge lifestyle’s importance but often lack practical direction, this document delivers actionable strategies for implementing and sustaining behavioral change, ACLM stated.1,2
The audience for the guideline is "any clinician or healthcare professional in a community or outpatient healthcare setting involved in managing non-pregnant adults with T2D, prediabetes or a history of gestational diabetes mellitus (GDM)," the authors wrote.2
The 14 recommendations, referred to as "key action statements," support clinicians in promoting lifestyle interventions as first-line management for prediabetes and type 2 diabetes, with an emphasis on the 6 core pillars of lifestyle medicine.
The guideline topline slide show above introduces primary care clinicians to the first codified approach to applied lifestyle change in diabetes care with an at-a-glance summary of the 14 recommendations.
A substantial body of evidence supports the greater efficacy of lifestyle interventions over metformin for preventing progression of prediabetes to T2D.3 A 2022 meta-analysis reported that the effects of the interventions on the risk of impaired glucose tolerance or prediabetes advancing to T2D was "significantly correlated with multiple lifestyle changes," with study participants reaching the greatest number of targets achieving more pronounced effects.4
"Although there are nearly 1,000 guiding documents for diabetes in the medical literature, and more than 350 pages of standards from the American Diabetes Association, they may not offer details and practice advice on lifestyle change," Richard M. Rosenfeld, MD, MPH, MBA, lead guideline author and ACLM director of guidelines and quality wrote.5 This guideline bridges that gap.
