Body mass index and/or waist circumference should be assessed at every visit, and the clinician should consistently encourage weight maintenance/reduction through an appropriate balance of lifestyle physical activity, structured exercise, caloric intake, and formal behavioral programs when indicated to maintain/achieve a body mass index .60 62,65 70 (Level of Evidence: B) 2. If waist circumference (measured horizontally at the iliac crest) is $35 inches ($89 cm) in women and $40 inches ($102 cm) in men, therapeutic lifestyle interventions should be intensified and focused on weight management.66 70 (Level of Evidence: B) 3. The initial goal of weight loss therapy should be to reduce body weight by approximately 5% to 10% from baseline. With success, further weight loss can be attempted if indicated. (Level of Evidence: C) Type 2 diabetes mellitus management Note: Recommendations below are for prevention of cardiovascular complications. Class I 1. Care for diabetes should be coordinated with the patient s primary care physician and/or endocrinologist. (Level of Evidence: C) 2. Lifestyle modifications including daily physical activity, weight management, blood pressure control, and lipid management are recommended for all patients with diabetes.19,22-24,29,56,58,59,62,66,74,162 (Level of Evidence: B) Class IIa 1. Metformin is an effective first-line pharmacotherapy and can be useful if not contraindicated.74 76 (Level of Evidence: A) 2. It is reasonable to individualize the intensity of blood sugar lowering interventions based on the individual patient s risk of hypoglycemia during treatment. (Level of Evidence: C) Class IIb 1. Initiation of pharmacotherapy interventions to achieve target HbA1c may be reasonable.71,72,74-80 (Level of Evidence: A) 2. A target HbA1c of #7% may be considered. (Level of Evidence: C) 3. 