Lifestyle change is the new trend for managing a patient’s diabetes, according to research. It is well established that diabetes mellitus (DM) is a progressive metabolic disorder, characterized by hallmark signs such as hyperglycemia, which is due to a deficiency of the hormone insulin. Besides glucose control, which is essential for patients who have DM, there is a strong need for patients to maintain a healthy and balanced life in order to avoid any complications. There are essentially seven key self-preservation behaviors in patients with diabetes that predict healthy outcomes, namely: eating well, being physically active, monitoring blood sugar regularly, compliance and adherence to the medications prescribed, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All seven of these behaviors have proven to show a positive correlation with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a drastic impact on the advancement and development of their disease by partaking in their own care. Despite this fact, when looking at a longer-term change in individuals, compliance and adherence to these activities is incredibly low.

In a new study published in US Endocrinology, researchers examined the effectiveness of nutrition and lifestyle modifications in improving diabetes outcomes. One of their essential focuses was on the “ABCs” of diabetes management: A1c, blood pressure and cholesterol. Maintaining an A1c level of about 7%, keeping your blood pressure <140/90mmHg, and maintaining LDL at <100mg/dL (with no cardiovascular disease) and an LDL of <70mg/dL with any type of cardiovascular complications, are key proponents in diabetes management, which is not only the responsibility of the healthcare provider and the medications prescribed to maintain, but the individual themselves. To achieve any of these goals, however, it is important to maintain an active lifestyle and to eat properly throughout the day; this is easier said than done, which is essentially one of the major issues faced by healthcare providers today.

Evidence-based medicine and research has shown a strong trend towards patients taking control of the disease state in their own hands, but that means changing a mindset. Medication on its own will help, but without pursuing a balanced lifestyle, complications will continue to arise and the progression of the disease will go on.

The question now is what exactly do you tell the patient and how should one go about making them realize how essential lifestyle modifications are to their health? For healthcare professionals, it is now vital for them to emphasize carbohydrate control and restricting sodium intake. One of the key findings for the research was the immense gap between these dietary recommendations and the actual dietary behaviors; this in part may be due to there being an overwhelming number of dietary behaviors for them to focus on. Patients typically get frustrated because there are too many rules and guidelines for them to follow with what to eat and what not to eat, and many times these suggestions are a “one-size fits all” type of recommendation. It is going to become essential for healthcare professionals to really tailor the nutrition plan for an individual based on their current profile–taking into account their social, economical and cultural background.

Incorporating healthy eating habits is just one part of diabetes self-care; a huge focus now is on physical activity, and this is where patients typically struggle the most. For many patients with diabetes, exercising regularly is not something they are accustomed to, but is something that must change in order to see any kind of improvement to their current state. Patients should be made more aware of why physical activity (from something as simple as just walking 30 minutes a day) is so important, how much is necessary for them to see changes, and why they must stay with it.

Practice Pearls:

Healthcare providers must make a clear clinical message to patients when reinforcing good dietary habits and exercise to help with diabetes management. Improving dietary habits and getting enough exercise daily are two simple ways for an individual to take charge of their health. In developing nutrition and lifestyle modifications for diabetes patients, each plan should be tailored specifically for each individual patient, taking into consideration a person’s entire background.

Researched and prepared by Javeria Fayyaz, Doctor of Pharmacy Candidate LECOM College of  Pharmacy, reviewed by Dave Joffe, BSPharm, CDE Delahanti, Linda M. “Improving Diabetes Outcomes through Nutrition and Lifestyle Change - Translating Research to Practice.” US Endocrinology. 2015. Web. 30 Jan. 2016.