T2D in most patients is highly responsive to weight opti- mization; weight loss can result in diabetes remis- sion for some patients and reduced medication use in most. 4. Multifactorial interventions to simultaneously improve diet quality, increase physical activity, and reduce body weight reduce risk for progression to diabetes among patients with impaired glucose tolerance by 43% to 58% during 3 to 5 years of The benefit achieved is in propor- tion to patients ability to achieve lifestyle goals. 5. Approximately 20% of patients with acute isch- emic stroke will be found to have undiagnosed diabetes after testing with an HbA1c or oral CLINICAL STATEMENTS AND GUIDELINES Kleindorfer glucose tolerance test.255 These patients are at risk for progressing to symptomatic disease and for developing complications related to their dia- betes, including microvascular and macrovascular disease. With the development of drugs that both control glucose and reduce risk for major adverse cardiovascular events, it has become more impor- tant to identify all patients with diabetes after an ischemic stroke so that they can be offered appro- priate therapy. Available methods to screen for diabetes include fasting blood sugar, oral glucose tolerance test, and HbA1c. Of these, HbA1c has advantages in that it is more convenient (ie, it does not require fasting), has less variability day to day, and is less likely to be perturbed by medications, stress, or illness.265 In general, HbA1c may be more accurate than other screening tests in the immedi- ate postevent period. It is probably the preferred method of diagnosis for patients hospitalized with an acute stroke. 6. Compared with evidence for a benefit in microvas- cular disease, there is less evidence for a benefit of intensive glucose control on macrovascular end points such as stroke. 