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New Lifestyle Recommendations for Type 2 Diabetes Released to Endocrinologists

Updated: 8/14/21 6:00 amPublished: 1/25/16

Twitter Summary: New recommendations announced by AACE/ACE w/ first-ever lifestyle therapy section – what they advise for sleep, nutrition, exercise + more!

Who tells doctors what to do? Lots of important organizations that help them organize their work. For example, endocrinologist organizations AACE/ACE recently published an updated version of their strategy recommendations (what they call their “algorithm”) for treating type 2 diabetes. 

The most substantial change in the 2016 recommendations is the addition of a new Lifestyle Therapy section. The section provides recommendations for nutrition, physical activity, sleep, behavioral support, and interventions to stop smoking. AACE/ACE offer recommendations for both baseline (moderate) interventions. The recommendations increase in intensity for patients with more severe obesity and obesity-related complications. They are outlined below:


Baseline Interventions

More Intense Interventions


Plant-based diet with limited saturated fat and no trans fat

Aim to maintain optimal weight

Calorie restriction with goal of 5-10% weight reduction if BMI ≥25

Structured counseling

Meal replacement

Physical Activity

150 min/week of moderate exertion plus strength training

Structured program

Medical evaluation/supervision for patients with limitations on physical activity


Seven hours per night

Screening for obstructive sleep apnea

Behavioral Support

Community engagement

Screening for anxiety and depression

Referral to mental health professional

Cognitive behavioral therapy

Smoking Cessation

No tobacco products

Structured programs

We love this Lifestyle Therapy section and think it's a very welcome addition – often the conversation about diabetes focuses too highly on drugs and devices, despite the enormous role of lifestyle and behavior in diabetes management. It is particularly refreshing to see AACE/ACE addressing aspects of lifestyle like sleep and mental health that are not always considered in traditional weight loss programs. Mental health is underfunded in virtually every disease area, and having major organizations raise awareness for mental health needs is crucial.

The document and its accompanying summary are added to the full 2015 clinical practice guidelines published last April. Along with the ADA/EASD position statement, the AACE/ACE algorithm is one of the most widely referenced sets of guidelines for type 2 diabetes management in the US. What do you think?


What do you think?