3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes—2024

Abstract

The American Diabetes Association (ADA) “Standards of 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, an interprofessional expert committee, 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 and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

Role of Weight Loss Induced Prediabetes Remission in the Prevention of Type 2 Diabetes – Time to Improve Diabetes Prevention

“…In summary, combining the recent ADA ‘Standards of Care for the Delay and Drevention of Diabetes’ recommendation for people with prediabetes to lose 7% of body weight [8] with the goal to reach remission from prediabetes to normal glucose regulation, reduces the relative risk to develop T2D by 76% within 6 years and importantly within the first 4 years, there was only one single incident diabetes case in this group, indicating that less than 1% of these patients develops diabetes after 4 years. As weight loss is a determining factor for the remission of prediabetes [6], we hypothesize that individuals with prediabetes who did not achieve remission (non-responders) after losing ≥7% of their body weight may benefit from continued weight loss until they reach their personal threshold [10,11].…”

“…Current American Diabetes Association (ADA) guidelines on the prevention of diabetes state that persons with prediabetes should lose body weight of 7% or more without setting glucose related target values [11]. We suggest that body weight loss and glycemic remission goals should be considered together, since weight loss and remission of prediabetes together offer the most efficient protection against the development of incident T2D.…”

“…Current American Diabetes Association (ADA) Standards of Care for prevention and delay of diabetes recommend that persons with prediabetes should lose body weight of ≥ 7%. Specific glucose target values are not recommended [8]. The 7% weight loss goal was chosen because it was feasible to achieve and maintain and was likely to reduce the risk of developing diabetes [8].…”

“…Specific glucose target values are not recommended [8]. The 7% weight loss goal was chosen because it was feasible to achieve and maintain and was likely to reduce the risk of developing diabetes [8].…”

“…To support this notion, we used data from the DPP (ClinicalTrials.gov registration no. NCT00004992) repository, which is the basis of the current Standards of Care of prevention or delay of diabetes by the ADA [8]. DPP was a randomized multicenter clinical trial that studied the effects of an intensive lifestyle intervention (ILS) and metformin on the prevention or delay of T2D in people with prediabetes.…”