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Treatment Overview

Lifestyle management

These recommendations are presented in abbreviated form. Readers should refer to the text of the guideline document for a detailed discussion of each of the following topics.

Recommendations

1. Advise people with Type 2 diabetes that lifestyle modification, by changing patterns of eating and physical activity, can be effective in controlling many of the adverse risk factors found in the condition.
2. Provide access to a dietician (nutritionist) or other health-care professional trained in the principles of nutrition, at or around the time of diagnosis, offering one initial consultation with two or three follow-up sessions, individually or in groups.
3. Provide ongoing counselling and assessment yearly as a routine, or more often as required or requested, and when changes in medication are made.
4. Individualize advice on food/meals to match needs, preferences, and culture.
5. Advise control of foods with high amounts of sugars, fats or alcohol.
6. Integrate drug therapy, where needed, into the individual’s chosen lifestyle.
7. For people choosing to use fixed insulin regimens, advise consistent carbohydrate intake at meals. For these people, as well as those on flexible meal-time + basal insulin regimens, offer education on assessment of carbohydrate content of different types of foods.
8. Provide advice on the use of foods in the prevention and management of hypoglycaemia where appropriate.
9. Introduce physical activity gradually, based on the individual’s willingness and ability, and setting individualized and specific goals.
10. Encourage increased duration and frequency of physical activity (where needed), up to 30-45 minutes on 3-5 days per week, or an accumulation of 150 minutes of physical activity per week.
11. Provide guidelines for adjusting medications (insulin) and/or adding carbohydrate for physical activity.
12. Both nutrition therapy and physical activity training should be incorporated into more broadly based diabetes self-management training programmes.
13. For weight reduction in people with Type 2 diabetes who are obese, it may sometimes be appropriate to consider weight loss medications as adjunct therapy.

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