A shift in the type 2 diabetes (T2D) treatment paradigm
Diet and lifestyle are key to addressing hyperglycemia and excess weight, however, pharmacotherapy should also be considered to help people living with diabetes achieve their individualized treatment goals1
When choosing glucose-lowering therapies for a patient with T2D and excess weight, like Ted, consider a regimen focused on lowering and weight reduction; this may include*:
Moderate Exercise1
Nutritional Changes1
Consistent Sleep Patterns1
Medication for Weight Management (as an adjunct to behavioral changes)1
*Discussion of metabolic surgery deferred as it does not apply to patient case.
The ADA-EASD Consensus Report recommends medications for glycemic control and weight management as adjuncts to lifestyle intervention1
When choosing glucose-lowering therapies, consider a regimen with high to very high glucose and weight efficacy1
ADA-EASD consensus report:1
“Weight loss of 5%-10% confers metabolic improvement; weight loss of 10%-15% or more can have a disease-modifying effect.”
Video series: Let’s Talk!
Navigating sensitive conversations about weight to support T2D management can be challenging. Watch this series illustrating a guideline-based approach with examples of how to have collaborative and effective conversations.
Assessing patient readiness
4:44
00:00-00:09
[Title screen animates inside a chat bubble; background music plays]
Caption: Let’s Talk
Why Achieving Early Glycemic Control Is So Important
00:09-00:24
[Illustrated female healthcare providers stands in frame, talking to the camera]
Healthcare provider: When individuals are first diagnosed with type two diabetes, they have many concerns to address. As a result, prioritizing a discussion on the importance of achieving their glucose targets from the start can be challenging.
00:24-00:53
[Camera starts to zoom out; the healthcare provider walks to her desk and sits down]
Healthcare provider: As clinicians, we understand the urgency of reaching these targets as soon as possible, and that the use of highly effective medications as early as possible can help achieve these goals. However, communicating this need without overwhelming patients can be difficult. Today, we will explore some potential ways to discuss the importance of early glycemic control in people with type two diabetes.
00:53-01:14
[The camera pans out, following an animated string; the animated string forms a circle; around this circle, the following illustrated icons appear, showing possible complications from diabetes—a human eye, kidneys, a human heart, a brain, and a prosthetic leg; a hemoglobin A1c meter with 7% in the middle appears on screen; the needle moves above 7%, to the red zone]
Narrator: It's important to remember that there is dysfunction of several important metabolic mechanisms that begins before diagnosis, and progresses over time. Studies have found that lowering HbA1C levels to 7% or less early after diagnosis is associated with a reduced risk of many future complications related to type two diabetes.
Caption: 2. Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786.
01:14-01:28
[As the meter needle starts to move backward into the green zone, the complication bubbles decrease in size; the phrase legacy effect animates above]
Narrator: Findings from these studies provide evidence for a legacy effect, demonstrating that achievement of the glycemic target early after diagnosis is associated with better long-term diabetes-related outcomes than delayed control.
Caption: 4. Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426.
Legacy Effect
01:28-01:57
[The female healthcare provider from before and a female patient sit across from each other in the provider's office; the camera pans upward while food, exercise, and prescription pad icons appear in the space above the HCP and patient; the HCP motions to the patient, and the 3 icons rotate, joining together with a connector string]
Healthcare provider: Although you have just been diagnosed with type two diabetes, it is likely that your body has been gradually developing this condition over a long period of time. Now that we know you have type two diabetes, we can act promptly by making lifestyle changes, including modifying important parts of your nutrition and increasing your physical activity. We can also use medications that can help improve your blood sugar and reduce your risk of diabetes complications.
01:57-02:06
[The camera zooms back to the patient; the string connecting the icons breaks apart as the patient questions the need for medication; diet and exercise each get a green check mark, but the medication icon gets larger, with a red question mark appearing inside the bubble]
Patient: This is a lot to take in. I'm ready to make changes to my diet, but is it necessary that I start taking medication right away?
02:06-02:26
[The camera zooms out to a full office shot then to the right, following the string to the window in the HCP’s office and then out to the open sky; the patient appears in a bubble with the hemoglobin A1c meter needle pointing in the red zone; the needle then goes down into the green zone as the patient gets slightly smaller]
Healthcare provider: Right now, we have a key window of opportunity to make a big impact on your journey with type two diabetes. By choosing a treatment plan that supports lifestyle changes and has the potential to address multiple causes of your high blood sugar, you may experience both short-term and long-term benefits.
02:26-02:37
[The bubble dissolves and the patient appears in the center of the screen relaxing on a tropical vacation; seagulls and ocean sound special effects are in the background]
Healthcare provider: Evidence has shown that if we get your blood sugar to target early after diagnosis, you may have long-term benefits in various aspects of your health related to diabetes.
02:37-02:45
[The vacation scene becomes a thought bubble next to the patient, who is still seated at the desk; she becomes excited, imagining herself enjoying life as she gets older]
Patient: I am open to exploring different treatments, but how can I reach my targets for controlling my type two diabetes?
02:45-03:04
[The camera zooms outward, revealing the HCP pulling down a screen showing a variety of medications; the medications animate, one by one, showing how they affect the needle of the HbA1c meter]
Healthcare provider: The good news is that today we have many effective treatments that, in addition to changes to lifestyle behaviors, can help you reach your individualized HbA1c goal. Some of these treatments can also help with weight management, which may benefit your diabetes care.
03:04-03:34
[The camera zooms in, and the female patient appears; exercise, diet, and question mark icons appear overhead; the meter needle stays in the amber area, and the patient gains weight; the prescription pad replaces the question mark icon, and the meter needle moves into the target goal icon; the patient looks slightly smaller and happy]
Narrator: Attaining early and sustained glycemic control is especially important for younger adults diagnosed with type two diabetes. Although they might present us healthier overall than older adults, younger adults with type two diabetes are actually at higher risk of future complications. ADA/EASD guidelines emphasize that attaining recommended HbA1C targets of less than 7% yields substantial and enduring reductions in the onset and progression of microvascular complications.
03:34-03:46
[The camera pans to the next scene showing the patient scrolling through her phone calendar to note a doctor’s follow-up visit in 3 months; text appears on screen; the camera zooms in on the new date]
Narrator: Early intervention in type two diabetes is essential, and it is recommended that patients who are not at their glycemic goal be reassessed every three months.
Caption: To avoid therapeutic inertia, reassess and modify treatment regularly (every 3-6 months)
03:46-04:05
[Three months later, the healthcare provider and the female patient are having another talk; the patient is excited and smiling]
Healthcare provider: By making lifestyle changes and starting on therapy right away, you've gotten your blood sugar below the target we set together three months ago. Your weight has also come down. Let's talk about the ways to maintain this great progress, and why it's important to keep your blood sugar well controlled.
04:05-04:17
Patient: That's wonderful news. I've been taking my medication, but I've also been working hard on my diet and adding more activity every day. I'm excited that my hard work is having an impact.
04:17-04:34
[The camera zooms in on the HCP’s face, and the Let’s Talk bubble animates on screen]
Healthcare provider: Having discussions like this with your patients can be difficult, but there are effective ways to highlight the importance of early glycemic control while remaining positive and encouraging. So, let's talk.
04:34-04:44
Caption:
References:
- American Diabetes Association Professional Practice Committee. 6. Glycemic goals and hypoglycemia: Standards of Care in Diabetes—2025. Diabetes Care. 2025;47(suppl 1)S111-S125.
- Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786.
- Kendall DM, Cuddihy RM, Bergenstal RM. Clinical application of incretin-based therapy: therapeutic potential, patient selection and clinical use. Am J Med. 2009;122(6 suppl):S37-S50.
- Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426.
- Sorensen BM, Houben AJHM, Berendschot TTJM, Schouten JSAG, et al. Prediabetes and type 2 diabetes are associated with generalized microvascular dysfunction. The Maastricht Study. Circulation. 2016;134(18):1339-1352.
- UK Prospective Diabetes Study Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) Lancet. 1998;352(9131):837-853.
- PP-TR-US-2871 08/2025 ©Lilly USA, LLC 2025. All rights reserved.
Assessing patient readiness
4:44
Advising and educating patients
4:53
Acknowledging the challenges of supporting patients in their diabetes care journeys
5:10
References
- Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786. doi:10.2337/dci22-0034