Fast Five Quiz: Glycemic Control in Type 2 Diabetes

Romesh Khardori, MD, PhD


July 23, 2021

Lifestyle changes, including physical activity and nutrition management, should be the foundation of any type 2 diabetes program. The European Society of Cardiology and the American Diabetes Association both recommend moderate to vigorous physical activity for ≥ 150 minutes per week for the prevention and control of type 2 diabetes. Nutrient distribution should be based on an individualized assessment of eating patterns, preferences, and metabolic goals. Although the evidence comparing the benefits of different eating patterns in specific individuals is not yet strong enough to make definitive conclusions, common key factors among the eating patterns include emphasizing nonstarchy vegetables, minimizing the intake of added sugars and refined grains, and choosing whole foods over highly processed foods to the extent possible.

The role of low-carbohydrate diets in type 2 diabetes remains unclear. A recent meta-analysis of 10 randomized controlled trials revealed that the glucose-lowering effects of low- and high-carbohydrate diets are similar at 1 year or later, with no significant effect on weight or low-density lipoprotein cholesterol levels. However, among diets that have been researched in the setting of type 2 diabetes, reducing overall carbohydrate intake has shown the most evidence for improving glycemia.

Metformin is the preferred first-line pharmacologic agent, but lifestyle changes should be the first measure for the prevention and management of type 2 diabetes. Several other antihyperglycemic agents are also approved for patients with type 2 diabetes in combination with proper diet and exercise. When the addition of oral or injectable agents has failed to lower the A1c level to target, insulin is an appropriate treatment option.

Learn more about lifestyle changes in type 2 diabetes.


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