Browse the evidence

Suboptimal dietary intake is responsible for 70.3% of global incident type 2 diabetes cases, with the largest burdens driven by insufficient whole-grain intake, excess refined rice and wheat, and excess processed meat.

Focus on increasing whole grains, reducing refined grains (rice/wheat), and limiting processed meats. These three factors alone account for the majority of diet-attributable diabetes risk globally.

Excess intake of harmful dietary factors (refined grains, processed meats, SSBs, potatoes, fruit juice) contributes a larger proportion (60.8%) of diet-attributable T2D burden than insufficient intake of protective factors (whole grains, yogurt, fruits, vegetables, nuts/seeds) (39.2%).

Prioritize cutting back on refined grains, processed meats, and sugary drinks. While eating more fruits and vegetables is beneficial, the biggest reduction in diabetes risk comes from reducing these specific harmful categories.

Dual GIP/GLP-1 receptor agonists (e.g., tirzepatide) and GLP-1 receptor agonists (e.g., semaglutide) induce significant weight loss and improve glycemic control in patients with type 2 diabetes and obesity by acting on central satiety centers and peripheral metabolic pathways.

If you have T2DM or obesity, GLP-1 and dual GIP/GLP-1 agonists are highly effective treatments that work by mimicking natural gut hormones to reduce appetite and improve blood sugar. They are available as weekly injections or daily oral pills. Consult your doctor to see if one of these FDA-approved medications is right for you.

Semaglutide 2.4 mg administered once weekly induces significant body weight reduction (>10% in ~69% of patients) in non-diabetic adults with obesity when used as an adjunct to lifestyle programs.

For non-diabetic adults with obesity, semaglutide 2.4 mg taken once weekly, combined with lifestyle changes, can lead to an average 14.9% body weight loss over 68 weeks. This is significantly more effective than placebo. Be prepared for potential gastrointestinal side effects like nausea, which are common but often subside.

An 18-week personalized dietary program (PDP) based on postprandial glucose, triglycerides, microbiome, and health history significantly reduces triglycerides, body weight, waist circumference, and HbA1c compared to standard USDA dietary guidelines.

Follow a personalized nutrition program that uses your body's specific response to food (glucose, triglycerides, microbiome) to guide your diet. This approach leads to greater improvements in triglycerides, weight loss, and blood sugar control compared to following standard government dietary guidelines alone. High adherence to the personalized advice is key to seeing these benefits.

Sodium bicarbonate supplementation (0.2–0.5 g/kg) improves performance in high-intensity exercise lasting 30 seconds to 12 minutes, including muscular endurance, combat sports, and high-intensity cycling, running, swimming, and rowing.

If you compete in high-intensity events lasting 30 seconds to 12 minutes (like a 400m run, boxing match, or rowing sprint), sodium bicarbonate can help. Start with 0.3 grams per kilogram of body weight, taken 60-180 minutes before your event. To avoid stomach issues, split the dose, take it with a high-carb meal, or use enteric-coated capsules. Do not exceed 0.3 g/kg for single doses as it increases side effects without adding benefit.

Sodium bicarbonate improves exercise performance in both men and women.

Women can benefit from sodium bicarbonate supplementation just as men do. Use the same dosing guidelines (0.3 g/kg) and timing (60-180 min pre-exercise).

Bariatric surgery leads to long-term nutrient deficiencies (anemia, neuropathies, osteoporosis) due to malabsorption and reduced gastric acid, requiring lifelong monitoring and supplementation.

After bariatric surgery, you must take lifelong vitamin and mineral supplements to prevent anemia, nerve damage, and bone loss. This is especially critical if you had a bypass procedure.

When total volume load (sets x reps x weight) is equated, high-load resistance training (≥80% 1RM) produces superior dynamic strength gains compared to low-load training (<60% 1RM), while muscle hypertrophy remains similar across all load magnitudes.

To maximize strength, prioritize heavier weights (80%+ 1RM). To maximize muscle size, you have flexibility: you can use heavy weights or lighter weights (as low as 30% 1RM), as long as you match the total amount of work (sets x reps x weight). You do not need to train to failure with lighter weights to get the same muscle growth as heavy weights.

A multicomponent mHealth intervention integrating smartphone apps, accelerometers, remote coaching, and modest financial incentives produces large, sustained improvements in multiple diet and physical activity behaviors, bringing them to public health guideline levels.

Use a smartphone app and a simple activity tracker to monitor your diet and movement. Set specific, achievable goals for increasing fruits/vegetables, reducing screen time, and increasing moderate-to-vigorous activity. Consider using a coaching service or app that provides feedback. Small, short-term financial incentives for meeting these goals can help kickstart the habit, but the key is consistent self-monitoring and support.

Muscle hypertrophy is driven by recurrent periods of positive net protein balance (NPB) resulting from resistance exercise coupled with protein feeding, rather than solely by transient increases in muscle protein synthesis (MPS) rates in the fasted state.

Do not train fasted if your goal is maximum muscle growth. Resistance exercise stimulates both muscle protein synthesis and breakdown, but in a fasted state, breakdown wins, resulting in a net loss. To build muscle, you must consume protein close to your workout to ensure your body stays in a positive protein balance over time.

Consumption of sugar-sweetened beverages (SSBs) is causally associated with a significant global burden of incident type 2 diabetes (T2D) and cardiovascular disease (CVD), mediated by both direct metabolic effects and adiposity.

Reduce or eliminate sugar-sweetened beverages to significantly lower your risk of developing type 2 diabetes and cardiovascular disease. The risk is not just from weight gain but from how sugar is metabolized directly. This is especially critical if you are young, male, or live in urban areas in high-burden regions like Latin America or Sub-Saharan Africa.

Dual GIP/GLP-1 receptor agonists (e.g., tirzepatide) produce greater body weight reduction than selective GLP-1 receptor agonists.

Tirzepatide, a dual-acting drug, is more effective for weight loss than standard GLP-1 drugs, achieving up to 21% weight loss in trials. It is taken once weekly, starting at a low dose to minimize stomach upset.

Tirzepatide, a GIP/GLP-1 receptor agonist administered via once-weekly subcutaneous injections, produces clinically significant reductions in HbA1c and body weight in patients with type 2 diabetes, demonstrating superior efficacy compared to standard antidiabetic therapies including GLP-1 RAs and insulin.

Tirzepatide is a once-weekly injection for type 2 diabetes that lowers blood sugar and reduces weight more effectively than many existing treatments. It starts at a low dose to minimize side effects like nausea, which usually improve over time. Patients should continue lifestyle changes like diet and exercise alongside the medication.

GLP-1 receptor agonists (semaglutide 2.4 mg and liraglutide 3 mg) produce significant body weight reduction (up to 20% with semaglutide) and improve cardiovascular risk factors, with semaglutide showing superiority in weight loss compared to previous drugs.

If lifestyle changes alone aren't enough, GLP-1 medications like semaglutide (2.4 mg weekly) are highly effective, producing up to 20% body weight loss in many patients. This weight loss is comparable to bariatric surgery and significantly improves blood pressure and cardiovascular risk. Discuss these options with your doctor if you have obesity and comorbidities.

Replacing regular salt with a potassium-enriched salt substitute (75% NaCl, 25% KCl) significantly reduces cardiovascular events and mortality, particularly in populations with low baseline potassium and high sodium intake.

If you have high blood pressure or eat a lot of salty food, consider using a potassium-enriched salt substitute (like Low-Sodium Salt) instead of regular table salt. This can significantly lower your risk of heart disease and stroke, especially if you live in an area where most salt comes from home cooking.

Semaglutide (both subcutaneous and oral formulations) provides superior glycemic control and greater weight loss compared to other GLP-1 receptor agonists, with demonstrated benefits in reducing major adverse cardiovascular events.

Semaglutide is a highly effective treatment for Type 2 Diabetes, offering better blood sugar control and weight loss than other drugs in its class. It is available as a weekly injection or a daily pill. If you choose the pill, you must take it on an empty stomach with a small sip of water and wait 30 minutes before eating. Start with the lowest dose to minimize stomach upset, which usually goes away. It also helps protect your heart and kidneys.

Bariatric surgery (RYGB and VSG) is more effective than intensive medical/lifestyle therapy for the resolution of type 2 diabetes, often occurring prior to significant weight loss.

If you have Type 2 Diabetes, surgery (RYGB or VSG) is significantly more effective at resolving the disease than medication and lifestyle changes alone. Resolution can happen even before significant weight loss. Patients with shorter diabetes duration and higher pre-op C-peptide levels have the best chance of resolution.

Weekly subcutaneous semaglutide (up to 1 mg) as an adjunct to automated insulin delivery significantly improves glycemic control (increasing time in range by 4.8 percentage points) and reduces body weight in adults with type 1 diabetes without increasing hypoglycemia risk.

If you have Type 1 Diabetes and use an automated insulin delivery system, adding weekly semaglutide (up to 1 mg) can significantly improve your time in range and help with weight loss without increasing the risk of low blood sugar. While gastrointestinal side effects are common, they are usually manageable, and the risk of ketosis, though present, can be mitigated with education and monitoring. This is a viable option, especially for those with higher BMI.

Tirzepatide significantly reduces body weight and improves lipid profiles (lowering LDL-C and triglycerides, raising HDL-C) in patients with T2DM and obesity.

Tirzepatide is a once-weekly injection that significantly reduces body weight and improves lipid profiles (lowering bad cholesterol and triglycerides, raising good cholesterol) in patients with T2DM and obesity. The benefits are dose-dependent.

Dual incretin agonists (GLP-1R/GIPR) such as tirzepatide offer superior weight loss and glycemic control compared to GLP-1 mono-agonists, with a safety profile comparable to mono-agonists.

Tirzepatide, a once-weekly injection targeting both GLP-1 and GIP receptors, has demonstrated significant weight loss (up to 22.5%) and improved blood sugar control in Phase 3 trials. Importantly, its side effect profile is similar to existing GLP-1 drugs, making it a highly effective option for managing obesity and type 2 diabetes.

Semaglutide 2.4 mg weekly induces mean weight loss of ~15% and enables >20% weight loss in significant patient subsets, significantly outperforming older anti-obesity medications and lifestyle interventions alone.

Semaglutide 2.4 mg, taken once weekly, is a highly effective treatment for obesity, producing an average 15% body weight loss over 68 weeks when combined with lifestyle changes. It significantly outperforms older medications and lifestyle interventions alone, helping to overcome the biological drive to regain weight. This treatment is suitable for adults with a BMI of 30 or higher, or 27 or higher with comorbidities, and requires a gradual dose escalation to manage side effects.

Tirzepatide, a dual GIP/GLP-1 receptor agonist, produces superior glycemic control and weight loss compared to GLP-1 receptor analogues (semaglutide, dulaglutide) in patients with type 2 diabetes.

For patients with Type 2 Diabetes seeking significant weight loss and glucose control, tirzepatide offers superior efficacy compared to existing GLP-1 analogues like semaglutide. It is administered as a once-weekly injection, starting at 5mg and titrating up to 15mg, combined with diet and exercise.

Tirzepatide 15 mg and semaglutide 1.0 mg, when added to metformin in type 2 diabetes, provide superior HbA1c reduction and weight loss compared to other GLP-1 receptor agonists, without increasing hypoglycemia risk.

For patients with Type 2 Diabetes on Metformin, Tirzepatide 15mg and Semaglutide 1.0mg are the most effective options for lowering blood sugar and losing weight among GLP-1 agonists. They do not increase hypoglycemia risk. If injections are a barrier, oral Semaglutide 14mg is a viable alternative with good efficacy.