Diabetes type 2

NUTRITION

• Limiting caloric intake to initiate weight loss, if overweight/obese (1)

• Focus on "minimally processed plant foods, such as whole grains, vegetables, whole  fruit, legumes, nuts, seeds and non-hydrogenated non-tropical vegetable  oils, while minimising the consumption of red and processed meats,  sodium, sugar-sweetened beverages and refined grains" (3)

• Mediterranean diet and DASH diet have the best supportive evidence for DM2 management (1)

• Mediterranean diets, vegetarian and vegan diets have shown both reduction in body weight, HbA1c, delayed requirement for diabetes medications, and benefits for cardiovascular health (2)

• Saturated fats: < 10% of daily calories (1)

• Sugars: Limit intake (1)

PHYSICAL ACTIVITY

• > 150 min / week of moderate to vigorous aerobic exercise (1)

• Exercise should be spread out over at least 3 times per week with maximum 2 consecutive days without exercise (1)

• 20-30 min of resistance exercise 2-3 times per week performed on non-consecutive days (1) Resistance exercise improves blood glucose levels (2)

• Vigorous physical activity may be contraindicated in proliferative diabetic neuropathy, and may be preferrable in severe peripheral neuropathy (1)

• Avoid prolonged sitting (1)

• Physical activity after meals are beneficial for glycaemic control (2)

WEIGHT LOSS

• Overweight/obesity: Weight loss improves HbA1c (2)

• Primary target weight loss for most people with DM2: 5-15% (2)

• 5-10% weight loss causes metabolic improvements (2)

• 10-15% weight loss, or more may lead to remission of DM2, and have benefits for CVD events and mortality (2)

SLEEP

• Sleep disorders are common among patients with DM2. Sleep apnoea is present in 50% of diabetes type 2 patients (2)

• Adequate vs poor sleep reduces HbA1c, blood pressure, blood lipids, possible symptoms of depression and improves quality of life (2)

SMOKING

• Diabetes patients who smoke should be offered help with smoking cessation (1)