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Question 1

What are some weight-related comorbidities that people with diabetes may have?

Answer 1

NAFLD, HF with preserved ejection fraction, obstructive sleep apnea

Question 2

What are the potential risks for people with type 2 diabetes and NAFLD?

Answer 2

Progression to more severe stages of liver disease, including NASH, hepatic fibrosis, and cirrhosis

Question 3

What are some recommended strategies for managing type 2 diabetes in people with NASH?

Answer 3

Lifestyle modification with a goal of weight loss, medical and/or surgical approaches to weight loss

Question 4

What are some recommended strategies for managing type 2 diabetes in people with NASH?

Answer 4

Lifestyle modification with a goal of weight loss, medical and/or surgical approaches to weight loss

Question 5

What are some recommended strategies for managing type 2 diabetes in people with NASH?

Answer 5

Lifestyle modification with a goal of weight loss, medical and/or surgical approaches to weight loss

Question 6

Which therapies have been shown to reduce NASH activity?

Answer 6

Pioglitazone therapy, GLP-1 RA therapy, metabolic surgery

Question 7

What is the suggested treatment for people with type 2 diabetes at intermediate to high risk of fibrosis?

Answer 7

Pioglitazone and/or a GLP-1 RA with evidence of benefit

Question 8

How can SGLT2i therapy benefit people with NAFLD?

Answer 8

Reducing elevated levels of liver enzymes and hepatic fat content

Question 9

How can SGLT2i therapy benefit people with NAFLD?

Answer 9

Reducing elevated levels of liver enzymes and hepatic fat content

Question 10

How can SGLT2i therapy benefit people with NAFLD?

Answer 10

Reducing elevated levels of liver enzymes and hepatic fat content

Question 11

What should be assessed and managed in people with NAFLD to minimize cardiovascular risk?

Answer 11

Cardiovascular risk factors

Question 12

How have SGLT2i drugs been shown to benefit people with obstructive sleep apnea?

Answer 12

Reducing incident obstructive sleep apnea

Question 13

What are the consensus recommendations for people with type 2 diabetes?

Answer 13

Access to ongoing DSMES programs, person-centered care, optimizing medication adherence, MNT, physical activity

Question 14

What are the consensus recommendations for people with type 2 diabetes?

Answer 14

Access to ongoing DSMES programs, person-centered care, optimizing medication adherence, MNT, physical activity

Question 15

What are the consensus recommendations for people with type 2 diabetes?

Answer 15

Access to ongoing DSMES programs, person-centered care, optimizing medication adherence, MNT, physical activity

Question 16

What is the recommended duration of physical activity for adults with type 2 diabetes?

Answer 16

> 150 min/week of moderate- to vigorous-intensity aerobic activity

Question 17

What types of training should be supplemented with aerobic activity for adults with type 2 diabetes?

Answer 17

Resistance, flexibility, and/or balance training

Question 18

When should metabolic surgery be considered as a treatment option for type 2 diabetes?

Answer 18

BMI ≥40.0 kg/m2 (BMI ≥37.5 kg/m2 in people of Asian ancestry) or a BMI of 35.0–39.9 kg/m2 (32.5–37.4 kg/m2 in people of Asian ancestry) who do not achieve durable weight loss and improvement in comorbidities

Question 19

When should metabolic surgery be considered as a treatment option for type 2 diabetes?

Answer 19

BMI ≥40.0 kg/m2 (BMI ≥37.5 kg/m2 in people of Asian ancestry) or a BMI of 35.0–39.9 kg/m2 (32.5–37.4 kg/m2 in people of Asian ancestry) who do not achieve durable weight loss and improvement in comorbidities

Question 20

When should metabolic surgery be considered as a treatment option for type 2 diabetes?

Answer 20

BMI ≥40.0 kg/m2 (BMI ≥37.5 kg/m2 in people of Asian ancestry) or a BMI of 35.0–39.9 kg/m2 (32.5–37.4 kg/m2 in people of Asian ancestry) who do not achieve durable weight loss and improvement in comorbidities

Question 21

What medications should be used in people with established CVD to reduce MACE?

Answer 21

GLP-1 RA or SGLT2i with proven benefit

Question 22

What medication should be initiated in people with CKD and an eGFR ≥20 ml/min per 1.73 m2 and a UACR >3.0 mg/mmol (>30 mg/g)?

Answer 22

SGLT2i with proven benefit

Question 23

What medication should be used in people with HF to improve HF and kidney outcomes?

Answer 23

SGLT2i

Question 24

What medication should be used in people with HF to improve HF and kidney outcomes?

Answer 24

SGLT2i

Question 25

What medication could be used in individuals without established CVD but with multiple cardiovascular risk factors?

Answer 25

GLP-1 RA or SGLT2i with proven benefit

Question 26

What medication could be used in individuals without established CVD but with multiple cardiovascular risk factors?

Answer 26

GLP-1 RA or SGLT2i with proven benefit

Question 27

What medication could be used in individuals without established CVD but with multiple cardiovascular risk factors?

Answer 27

GLP-1 RA or SGLT2i with proven benefit

Question 28

Should the decision to use a GLP-1 RA or SGLT2i be dependent on baseline HbA1c?

Answer 28

No, it should be independent of baseline HbA1c

Question 29

Should medication selection for improving cardiovascular and kidney outcomes differ for older people?

Answer 29

No, it should not differ

Question 30

What is the recommended approach for younger people with diabetes (<40 years)?

Answer 30

Consider early combination therapy

Question 31

What counseling is important for women with reproductive potential?

Answer 31

Contraception and avoiding exposure to medications that may adversely affect a fetus