Unlike type 1 diabetes mellitus (an autoimmune condition largely unrelated to lifestyle factors), the development and progression of T2DM are heavily influenced by dietary pattern, physical activity, and body weight. Approximately 12% of US adults have diabetes, 90% to 95% of whom have T2DM, with sig- nificant heterogeneity according to age, sex, race/eth- nicity, and socioeconomic status.S4.2-15 Alarmingly, more than one-third of US adults ( 80 million adults) have prediabetes and are at risk of developing T2DM.S4.2-15 * Although contemporary data have shown a sig- nificant decrease in ASCVD rates in individuals with T2DM remains a highly prevalent disease and a major ASCVD risk factor. An aggressive, com- prehensive approach to ASCVD risk factor treatment in adults with T2DM reduces ASCVD events.S4.2-16 Man- agement of cholesterol and hypertension in adults with T2DM is discussed in the relevant sections of the pres- ent guideline (see Sections 4.3. and 4.4.). Recommendation-Specific Supportive Text 1. A heart-healthy dietary pattern is a key intervention in the treatment of T2DM. The Mediterranean, DASH, and vegetarian/vegan diets have all been shown to help in the achievement of weight loss and improve glycemic control in T2DM.S4.2-1,S4.2-2 Prospective cohorts have demonstrated a significantly Recommendations for Adults With Type 2 Diabetes Mellitus (Continued) COR LOE Recommendations *An HbA1c is the optimal screening method, with a level 6.5% indicating T2DM. 