Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

What does current evidence suggest about the effect of weight loss on diabetes prevention?

1. Improves glycemia in most individuals with diabetes.

2. Does not prevent diabetes unless weight loss is greater than 20%.

3. Improves glycemia more in individuals who are insulin deficient.

4. Has less effect on individuals with long-standing diabetes.

The correct answer is: Has less effect on individuals with long-standing diabetes.

Current evidence suggests that weight loss has varying effects depending on the duration and progression of diabetes in individuals. For those with long-standing diabetes, the potential for weight loss to significantly impact glycemic control tends to diminish. This is primarily because chronic diabetes can lead to more advanced beta-cell dysfunction, insulin resistance, and alterations in metabolism. In such cases, the physiological changes that have occurred may render weight loss less effective in improving glycemic control compared to individuals who are newly diagnosed or those in earlier stages of diabetes management. In contrast, recent studies indicate that weight loss can have notable benefits in preventing diabetes development, particularly for individuals who are at risk or have recently been diagnosed with the condition. For these individuals, even modest weight loss can lead to substantial improvements in insulin sensitivity and overall metabolic health. Understanding the temporal aspect of diabetes is crucial, as it helps tailor weight loss interventions more effectively. Therefore, focusing on individuals with long-standing diabetes highlights the need for additional strategies beyond weight management to achieve optimal glycemic control.