The role of medical nutritional therapy and physical activity as part of T2DM self-management should never be neglected and requires constant reinforcement with the patient and positive coaching. For example, data show that regardless of what diet is used (eg, Zone, Ornish, South Beach), it is the nutritional program that a patient can persist with that will have the greatest success.
39-42 Recent evidence continues to support the use of the Dietary Approaches to Stop Hypertension diet in managing risk factors for T2DM
43 and has recently been shown to be of specific benefit in women with gestational diabetes.
44 New nutritional guidelines from the ADA focus on overall eating patterns without recommending any one form of diet while reviewing the evidence for several popular eating plans.
45 The American College of Sports Medicine and the ADA have issued a joint position statement on exercise and T2DM that may be useful.
46 In general, the ADA recommends that adults perform at least 150 minutes per week of moderate-intensity aerobic physical activity (at 50%-70% of maximum heart rate), spread over at least 3 days per week with no more than 2 consecutive days without physical activity.
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