-
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.
-
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.
-
Provide ongoing counselling and assessment yearly as a routine, or more often as required or requested, and when changes in medication are made.
-
Individualize advice on food/meals to match needs, preferences, and culture.
-
Advise control of foods with high amounts of sugars, fats or alcohol.
-
Integrate drug therapy, where needed, into the individual’s chosen lifestyle.
-
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.
-
Provide advice on the use of foods in the prevention and management of hypoglycaemia where appropriate.
-
Introduce physical activity gradually, based on the individual’s willingness and ability, and setting individualized and specific goals.
-
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.
-
Provide guidelines for adjusting medications (insulin) and/or adding carbohydrate for physical activity.
-
Both nutrition therapy and physical activity training should be incorporated into more broadly based diabetes self-management training programmes.
-
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.