Lifestyle Management of Type 2 Diabetes Mellitus

Once type 2 diabetes mellitus is diag­nosed, lifestyle management is a corner­stone of clinical care. This section reviews some of the evidence from large clinical trials that focus on lifestyle management in type 2 diabetes mellitus. Physical Activity The Look AHEAD (Action for Health in Di­abetes) study, conducted from 2001 to 2012, provided extensive longitudinal data on the effect of an intensive lifestyle management intervention, targeting weight reduction through caloric restriction and increased physical activity, on CVD rates (the pri­mary outcome) and CVD risk factors among adults with type 2 diabetes melli­tus. In this trial, 2,575 participants were randomized to a control group and 2,570 to an intervention that consisted of a weekly goal for physical activity of 50 min/week initially, increasing to 175min/week of moderately intense activity by week 26 (34). The second component of the physical activity intervention included a focus on lifestyle activity (e.g., using the stairs instead of elevators, walk­ing instead of riding), which is equally as effective as aerobic activity in leading to weight loss and improvement in CVD risk factors (35). Participants were provided a pedometer in the seventh week and in­structed to increase their daily steps by 250 each week until they reached the goal of 10,000 a day. One-year results revealed that participants in the intensive lifestyle intervention achieved an average of 136.7 ± 110.4 min/week of physical activity; moreover, there...

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