- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
The Role of Weight Management and Glycemic Control in the Management of Type 2 Diabetes
Panelists discuss how treating obesity as the root cause can create a "virtuous cycle" where weight loss improves insulin resistance, reduces medication needs, and enables better physical activity, breaking the traditional reactive approach to diabetes management.
EP: 1.Hormonal Adaptations in Type 2 Diabetes and Obesity
EP: 2.Importance of Clinical Trials and Guideline Recommendations
EP: 3.Barriers Associated with Guideline-Directed Care
EP: 4.The Role of Weight Management and Glycemic Control in the Management of Type 2 Diabetes
EP: 5.Improving Patient Outcomes Beyond Glycemic Control
EP: 6.Taking a Cardiometabolic Health Approach in Patients with Type 2 Diabetes
EP: 7.Seamless Management Between Primary Care Providers and Specialists
EP: 8.Supporting Patients and Primary Care Providers
EP: 9.Optimizing the Clinician-Patient Relationship
EP: 10.Overcoming Weight Bias in Clinical Practice
EP: 11.Creating a Positive Culture Around Weight Discussions
EP: 12.Leveraging Registries and Data Analytics
EP: 13.Structured Care Pathways and Predictive Modeling
EP: 14.Additional Clinical Considerations for the Management of Obesity
Clinical Barriers and Implementation Challenges
Healthcare providers face significant barriers in implementing comprehensive obesity management for patients with type 2 diabetes. The primary challenge is insufficient time for patient-centered, shared decision-making and motivational interviewing required to understand social determinants of health. Most providers lack access to multidisciplinary teams proven effective for chronic disease management, which operates as a team sport rather than individual physician responsibility.
Many providers lack adequate education and training in obesity management, as this wasn't part of traditional medical school curricula. This knowledge gap can create clinical inertia, leading to underutilization of beneficial programs and medications, particularly those offering cardio-renal risk reduction. The implementation of new evidence typically takes 5-7 years in healthcare systems, creating delays in adopting proven interventions.
Cost considerations present additional challenges, as medications and programs are expensive while affecting 40% of the population. Healthcare systems struggle to provide cost-effective access to beneficial treatments within limited resource constraints. Despite these barriers, the availability of evidence-based treatment strategies that impact cardio-renal risk and decrease mortality represents an unprecedented opportunity, requiring systematic approaches to overcome implementation obstacles.
Integrated Care for Chronic Conditions: A Randomized Care Management Trial
December 3rd 2025The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.
Read More
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
Read More
