From the Guidelines
Lifestyle modifications, including a calorie-restricted diet and regular physical activity, are essential for the management of Type 2 Diabetes Mellitus (T2DM), with the goal of achieving a weight loss of 5-10% of body weight, as this has been shown to improve glycemic control, reduce cardiovascular risk factors, and improve quality of life 1.
Key Lifestyle Modifications
- A calorie-restricted diet emphasizing vegetables, fruits, whole grains, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods, is recommended to achieve weight loss and improve glycemic control 1.
- Regular physical activity of at least 150 minutes of moderate-intensity exercise weekly, spread over at least 3 days with no more than 2 consecutive days without activity, is essential for improving insulin sensitivity and reducing cardiovascular risk factors 1.
- Smoking cessation and limiting alcohol consumption are also important lifestyle modifications for patients with T2DM 1.
Weight Loss Goals
- A weight loss of 5-10% of body weight is recommended for patients with T2DM, as this has been shown to improve glycemic control and reduce cardiovascular risk factors 1.
- Greater weight loss may produce even greater benefits, including reductions in blood pressure, improvements in LDL and HDL cholesterol, and reductions in the need for medications to control blood glucose, blood pressure, and lipids 1.
Dietary Recommendations
- A Mediterranean diet supplemented with olive oil and/or nuts has been shown to reduce the incidence of major cardiovascular events in patients with T2DM 1.
- Eating plans should be individualized to meet the patient's protein, fat, and carbohydrate needs while still promoting weight loss 1.
Physical Activity Recommendations
- Moderate-to-vigorous physical activity of >150 min/week is recommended for the prevention and control of T2DM 1.
- High levels of physical activity (200-300 min/week) are recommended for patients who achieve short-term weight-loss goals, as part of a long-term weight maintenance program 1.
From the FDA Drug Label
Metformin hydrochloride tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus. The recommended lifestyle modifications for patients with Type 2 Diabetes Mellitus (T2DM) include:
- Diet: as an adjunct to medication
- Exercise: to improve glycemic control 2
From the Research
Lifestyle Modifications for T2DM
- Lifestyle modifications play a crucial role in the management of Type 2 Diabetes Mellitus (T2DM) 3
- These modifications can help achieve better management of diabetes by governing the interplay between genetics and environmental factors 3
- Recommended lifestyle modifications include physical activity and dietary changes
Physical Activity Guidelines
- Adults with T2D should engage in at least 150 min of moderate aerobic exercise per week 4
- Adaptations for T2D focus on glucose levels, diet, foot care, weather conditions, sedentary behaviour, neuropathy, and retinopathy 4
- There is limited emphasis on strength and flexibility exercises in current guidelines 4
Dietary Changes
- Carbohydrate-restricted diets have been used effectively to treat obesity and T2DM for over 100 years 5
- The effectiveness of these diets may be due to lowering the dietary contribution to glucose and insulin levels, leading to improvements in hyperglycemia and hyperinsulinemia 5
Treatment Options
- Metformin is one of the oldest antidiabetic medications, commonly used in the management of T2DM 6, 7
- Its mechanism of action is based on reducing glucose production in the liver, decreasing insulin resistance, and increasing insulin sensitivity 6
- Metformin can be used as the first-line agent in the management of diabetes, but newer agents may be favored in individuals with cardio-renal protection needs 6