Browse the evidence

Specific hypoglycemic agents, SGLT-2 inhibitors and GLP-1 receptor agonists, reduce cardiovascular event risk in patients with diabetes, particularly those with a history of CVD, independent of glycemic control levels.

If you have diabetes and a history of heart disease, ask your doctor about SGLT-2 inhibitors or GLP-1 receptor agonists, as they may offer heart protection benefits beyond just lowering blood sugar.

Intensive blood pressure lowering to <130 mm Hg may be better tolerated and beneficial for perimenopausal women with diabetes compared to older populations, though standard guidelines recommend <140/90 mm Hg.

Discuss with your doctor if a lower blood pressure target (below 130 systolic) is appropriate for you, as younger women may tolerate it better than older patients, potentially offering more stroke protection.

A 12-item, 5-minute online diet quality assessment (WELL Diet Score) yields scores significantly correlated with established, lengthy 127-item Food Frequency Questionnaires (AHEI-2010), validating its use for rapid, large-scale diet quality assessment.

If you need to track your diet for a long-term health goal or research study but hate filling out long forms, use a validated short-form diet tracker. This study shows that a 12-question survey can accurately reflect your overall diet quality just as well as a much longer, more tedious questionnaire, making it easier to stick with the habit of tracking.

Omitting initial glucose-lowering drug treatment (GLDT) in newly diagnosed type 2 diabetes is associated with a higher 5-year risk of major adverse cardiovascular events (MACE), primarily mediated by lower initiation of statins and renin-angiotensin system inhibitors (RASi), even in patients achieving glycemic remission.

If you have newly diagnosed type 2 diabetes, even if you manage to normalize your blood sugar through diet and exercise (remission), you may still be at higher risk for heart attacks or strokes if you avoid glucose-lowering drugs. This is likely because avoiding these drugs also means you are less likely to be prescribed essential heart-protective medications like statins or blood pressure drugs. Ensure your doctor prescribes appropriate cardiovascular prevention strategies regardless of your glycemic status.

Obesity is a chronic disease requiring comprehensive clinical evaluation and staging (e.g., EOSS, Kings criteria) rather than reliance on BMI alone, as BMI has low sensitivity for adiposity and fails to capture complication risk.

Do not rely on BMI alone to assess your health risks. Ask your doctor for a comprehensive evaluation that includes staging criteria (like EOSS or Kings) and metabolic health markers (blood pressure, lipids, glucose). This ensures you get the right level of care, whether it's lifestyle changes, medication, or surgery, rather than just being told to 'lose weight'.

Metabolic health status (MHO vs. MUO) is a better predictor of long-term cardiovascular risk and mortality than BMI alone, with metabolically unhealthy obesity (MUO) requiring prompt intervention.

If you have obesity, ask your doctor to check your metabolic health (blood pressure, lipids, blood sugar), not just your weight. Your risk of heart disease depends more on these numbers and where you store fat (belly vs. hips) than your BMI alone. If you are metabolically unhealthy, you need prompt intervention.

Strength training protocols for people with haemophilia are frequently under-reported regarding critical safety and efficacy variables, specifically pain threshold, prophylactic factor coverage, intensity, range of motion, and time under tension.

If you have haemophilia and are doing strength training, ensure your protocol clearly specifies pain limits (like a 0-2/10 scale), how your clotting factor treatment aligns with exercise days, and the exact intensity and range of motion. This transparency is crucial for safety and effectiveness, as current practices often omit these details.

Insulin resistance does not prevent weight loss; insulin-resistant individuals lose weight to the same degree as insulin-sensitive individuals when following a hypocaloric diet.

If you have insulin resistance, you can still lose weight. You do not need a special diet or medication to overcome your biology. A caloric deficit will work for you just as it does for anyone else. Focus on creating a sustainable calorie deficit and you will see results.

Obesity stigma independently worsens mental and physical health outcomes, increases cortisol and oxidative stress, and promotes weight gain through avoidance of healthcare and unhealthy coping behaviors.

If you have obesity, know that stigma is a major barrier to your health, not a motivator. Avoiding doctors due to fear of judgment often leads to worse health outcomes. Seek providers who use 'people-first' language and focus on your overall well-being rather than just your weight. This reduces stress and improves adherence to treatment.

Implementing patient-centered care and 'people-first' language reduces stigma, improves patient adherence, and enhances therapeutic outcomes in obesity management.

Healthcare providers should use 'people-first' language (e.g., 'patient with obesity' instead of 'obese patient') and focus on the patient's perspective. This builds trust, reduces stigma, and improves the patient's likelihood of adhering to lifestyle, pharmacological, or surgical treatments.

Fourier transform near-infrared (FT-NIR) spectroscopy provides body fat measurements comparable to dual-energy X-ray absorptiometry (DXA) in overweight and obese premenopausal women, making it a valid, rapid, and portable alternative for monitoring body composition changes.

If you are overweight or obese, relying solely on BMI or scale weight can be misleading because it doesn't tell you how much of your weight is fat versus muscle. FT-NIR technology offers a quick, non-invasive, and portable way to measure body fat accurately, similar to expensive lab scans like DXA. This allows for better monitoring of fat loss progress during diet and exercise interventions without the radiation exposure or cost of DXA.

Lowering blood glucose levels reverses glucose toxicity, thereby restoring beta-cell insulin secretion and enabling complete or partial remission of type 2 diabetes.

If you have Type 2 Diabetes, high blood sugar actively suppresses your pancreas's ability to make insulin. This suppression is often reversible. By aggressively lowering your blood glucose levels—through medication, intensive insulin therapy, or dietary changes—you can remove this 'glucose toxicity.' This allows your remaining beta-cells to recover function, potentially leading to remission where you no longer need medication. This is most likely if you have not had diabetes for many years and still have some beta-cell mass left.

Non-physician health workers (NPHW) leading comprehensive care models, including screening, counseling, and medication management under physician supervision, effectively improve blood pressure control and reduce cardiovascular risk scores.

In settings with limited physician access, utilizing trained non-physician health workers for screening, counseling, and medication management under supervision can significantly improve blood pressure control and reduce cardiovascular risk.

Consuming plant-based meat alternatives instead of animal meat reduces dietary acid load, evidenced by lower urinary excretion of sulfate, ammonium, phosphorus, and urea nitrogen, and higher urine pH and citrate levels in healthy adults.

If you are concerned about kidney health or urinary stone risk, switching from animal meat to plant-based meat alternatives (consuming at least 2 servings daily) can help reduce the acid load on your kidneys. This shift lowers harmful urinary acids and increases protective citrate, potentially offering benefits similar to eating more vegetables, without requiring a complete change in taste preferences.

Weight-inclusive, non-diet approaches (e.g., HAES) improve metabolic and psychological health outcomes without requiring weight loss, whereas weight-focused approaches may perpetuate stigma and weight cycling.

You can improve your health without losing weight. Focus on behaviors like moving your body, eating nutrient-dense foods, and managing stress. These 'weight-inclusive' strategies can improve blood pressure, lipids, and mental well-being, even if the scale doesn't change.

The term 'non-responder' should be restricted to specific organs or physiological functions rather than applied to the whole individual, as exercise-induced adaptation is systemic and a lack of response in one area (e.g., VO2max) does not preclude adaptation in others (e.g., immune function or muscle metabolism).

If you aren't seeing improvements in your main goal (like running faster or lifting heavier), don't assume exercise isn't working for you. Your body is likely adapting in other ways, such as improved immune function, better blood flow, or metabolic health. The 'right' exercise for you might be different from what you are currently doing, so consider adjusting the type or intensity of your training rather than stopping.

Higher baseline daytime physical activity is associated with better endothelial function (measured by Reactive Hyperemia Index) five years later in both patients with type 2 diabetes and non-diabetic controls.

Maintain consistent daytime movement. This study suggests that higher levels of daily activity, measured objectively, are linked to better blood vessel health five years later, regardless of diabetes status. You do not need intense gym sessions; consistent daily activity (counts per minute) matters for long-term vascular function.

In type 2 diabetes patients initiating insulin therapy, pre-insulin weight loss combined with rising or persistently high HbA1c is the strongest predictor of excessive post-initiation weight gain (≥5 kg).

If you are starting insulin and have lost weight recently while your blood sugar numbers were going up, expect to regain that weight. This is likely 'catch-up' weight as your body stops losing sugar through urine. It is a sign the insulin is working to correct your metabolism, not necessarily a failure of your diet. Monitor your weight, but do not let fear of this specific type of gain prevent you from starting life-saving therapy.

Metformin therapy reduces the risk of developing type 2 diabetes in patients with prediabetes, with the greatest preventive effect observed in individuals with higher baseline glycated hemoglobin (HbA1c) and a history of gestational diabetes.

If you have prediabetes, especially if your HbA1c is on the higher side (6.0-6.4%) or you had gestational diabetes, metformin is a proven, safe option to prevent type 2 diabetes. It works by improving how your liver handles glucose and insulin. It does not cause low blood sugar, making it a low-risk preventive tool when lifestyle changes alone are not enough.

Acarbose, an alpha-glucosidase inhibitor, reduces the risk of developing type 2 diabetes in patients with impaired glucose tolerance, but its effectiveness is lower than that of lifestyle modification and metformin.

Acarbose can help prevent diabetes in people with prediabetes by slowing down carb absorption, but it is less effective than lifestyle changes or metformin. It often causes bloating and stomach discomfort, leading many people to stop taking it. It is generally not the first choice for prevention.

Consumption of 5g/day of the human milk oligosaccharide 2'-fucosyllactose (2'-FL) for 6 weeks significantly increases the relative abundance of Bifidobacterium in the gut microbiota of healthy older adults.

For older adults looking to support gut health, consuming 5g of 2'-FL daily for 6 weeks is a well-tolerated intervention that significantly increases beneficial Bifidobacterium levels. While it did not change the primary immune score, it did increase HDL cholesterol and fasting insulin. Users should expect this effect to be reversible upon stopping supplementation.

High-dose 2'-FL supplementation (5g/day) in older adults significantly increases serum levels of Fibroblast Growth Factor 21 (FGF21) and HDL cholesterol, while depleting octanoylcarnitine.

Older adults taking 5g of 2'-FL daily may see improvements in HDL cholesterol and levels of the hormone FGF21, which regulates lipid metabolism. These changes are associated with the bloom of Bifidobacterium in the gut. The intervention is well-tolerated.

Addressing mental health issues, particularly depression and anxiety, through screening and intervention improves glycemic control in patients with Type 2 Diabetes.

If you are struggling with depression or anxiety, talk to your healthcare provider. Treating mental health issues can help you manage your diabetes better and improve your blood sugar levels. Pharmacists can help screen for these issues and refer you to appropriate resources.

Low serum creatinine levels in early pregnancy (10-14 weeks) are associated with a significantly higher incidence of postpartum abnormal glucose metabolism (AGM) in women with a history of gestational diabetes mellitus (GDM).

If you have a history of gestational diabetes, your early pregnancy creatinine level may predict your risk of developing persistent blood sugar issues after birth. Since creatinine reflects muscle mass, and muscle is key for processing glucose, maintaining or building muscle mass through resistance training and adequate protein intake before and during pregnancy may help mitigate this risk. Discuss your creatinine levels with your endocrinologist or obstetrician as part of your GDM management plan.