According to ADA 2025 Standards, more intensive preventive approaches should be considered in individuals who are at particularly high risk of progression to diabetes, including individuals with BMI ≥35 kg/m2 who:
- Sit more than eight hours a day and have a sedentary lifestyle.
- Have a history of thyroid or celiac disease.
- Consume a diet with high amounts of simple carbohydrates.
- Have fasting plasma glucose of 110–125 or A1C ≥6.0%.
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