3.1 Treatment regimen and monitoring

Lifestyle modification includes medical nutrition therapy and exercise.

Medical nutrition therapy

An individualized medical nutrition therapy preferably by a registered dietitian, is recommended for all people with diabetes and prediabetes. Typical composition of a balanced diet should be carbohydrate 50%, protein 10-20%, fat<30%. Meal plans should be individualized while keeping total calorie and metabolic goals in mind.

Table 3.3 Factors related to medical nutrition therapy

Exercise/physical activity³

• Adults with diabetes should perform150 minutes or more of moderate intensity aerobic activity per week, spread over at least 5 days/week, with no more than 2 consecutive days without activity.
• Shorter durations (minimum 75 min/week) of moderate intensity or interval training may be sufficient for younger and more physically fit individuals.
• Adults with diabetes should engage in 2-3 sessions/week of resistance exercise on non-consecutive days.
• All adults and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behavior, prolonged sitting should be interrupted every 30 minutes.
• Physical activity or exercise is encouraged to do same time in a day.

Table 3.4 Some practical points on exercise²

Type and duration of exercise may vary in some special instances as shown in the following table.

Table 3.5 Exercise in special situations²

Oral drugs, insulin and other injectable agents are used for management of diabetes. Several individual and drug factors are considered while choosing an antidiabetic agent. Selection of antidiabetic agent is always individualized and may vary in same person in different situation.

Figure 3.1 Type 2 diabetes management algorithm
(Adapted from Diabetes Care, BADAS Guideline 2019)