2014糖尿病指南: 生活习惯的改变Lifestyle Changes

2014糖尿病指南: 生活习惯的改变Lifestyle Changes

Medical Nutrition Therapy

Nutrition therapy for all patients with type 1 and type 2 diabetes
  • As part of overall treatment plan

Prediabetes or diabetes
   - Individualized medical nutrition therapy as needed to achieve treatment targets, preferably provided by registered dietitian

Individuals at high risk for developing type 2 diabetes
  Begin structured program, emphasizing lifestyle changes, including →
    • Moderate weight loss (7% body weight)
    • Regular physical activity (150 min/wk) with dietary strategies, including reduced caloric and fat intake

Achieve dietary fiber intake of 14 g/1,000 kcal and whole grains 50% of grain intake

Physical Activity

Adults with diabetes
Exercise programs should include
    • ≥150 min/wk moderate-intensity aerobic activity (50%-70% max heart rate), spread over
≥3 days/wk with no more than 2 consecutive days without exercise
    • Resistance training ≥2 times/wk (in absence of contraindications)*

Evaluate patients for contraindications prohibiting certain types of exercise before recommending
exercise program†

Consider age and previous level of physical activity

Children with diabetes, prediabetes
≥60 min physical activity/day
*Adults with type 2 diabetes
†Eg, uncontrolled hypertension, severe autonomic or peripheral neuropathy, history of foot lesions,
unstable proliferative retinopathy

Smoking Cessation

   -Advise patients with diabetes not to smoke or use tobacco products
   -Counsel on smoking prevention and cessation as part of routine care
   -Assess level of nicotine dependence
   -Offer pharmacologic therapy as appropriate