Diabetes mellitus, particularly type 2 diabetes, has become a significant global health concern. This paper reviews the evidence supporting incorporating lifestyle changes and nutritional strategies into diabetes management and their potential benefits on glycemic control and overall health outcomes.

Introduction

1. Diabetes mellitus is a chronic condition characterised by elevated blood glucose levels due to impaired insulin secretion, insulin action, or both.
2. According to the International Diabetes Federation (IDF), as of 2021, approximately 537 million adults aged 20–79 were living with diabetes, a number projected to rise to 643 million by 2030 [5].
3. While conventional diabetes management primarily focuses on pharmacotherapy, the role of lifestyle and nutritional interventions is increasingly recognised as a fundamental component of comprehensive diabetes care [1].

The role of lifestyle interventions

Physical activity

Regular physical activity is critical in managing diabetes. It enhances insulin sensitivity, aids in weight loss, and lowers cardiovascular risk [3]. The ADA recommends at least 150 minutes of moderate-intensity aerobic activity weekly, combined with resistance training on two or more days per week [1]. A study demonstrated that individuals who engaged in regular physical activity experienced greater improvements in glycemic control compared to those who remained sedentary.

Weight management

Obesity is a significant risk factor for developing Type 2 diabetes, and weight loss has been shown to improve glycemic levels and cardiovascular health [4]. The Look AHEAD (Action for Health in Diabetes) study highlighted that participants who achieved a 7% reduction in body weight through lifestyle modification had a more significant reduction in haemoglobin A1c levels [7].

Stress management and sleep

Chronic stress and poor sleep quality can negatively impact blood glucose levels. Stress management techniques, including mindfulness, yoga, and cognitive behavioural therapy, have been found to improve glycemic control and psychological well-being [6]. Furthermore, establishing healthy sleep patterns supports metabolic health, with studies indicating that adequate sleep improves insulin sensitivity and glucose metabolism [11].

Nutritional interventions

Dietary patterns

The quality of dietary choices plays a pivotal role in diabetes management. Diets rich in whole grains, legumes, fruits, vegetables, lean proteins, and healthy fats are associated with improved glycemic control and a reduced risk of diabetes complications (7,8). The Mediterranean diet, which emphasises these food groups, has garnered attention for its anti-inflammatory effects and benefits on glycemic control [9].

Carbohydrate management

Carbohydrate counting and glycemic index awareness are crucial for managing blood sugar levels. Research indicates that substituting high glycemic index carbohydrates with low glycemic index alternatives can lead to lower postprandial glucose levels [2]. Additionally, integrating dietary education can empower patients to make informed choices that support their management goals.

Meal timing and frequency

Emerging evidence suggests that meal timing and frequency may affect diabetes management. Time-restricted eating and intermittent fasting have demonstrated potential benefits in improving insulin sensitivity and reducing overall caloric intake [8]. However, further research is needed to establish standardised guidelines.

Disclaimer- The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of M3 India.

About the author of this article: Dr Partha Ghosh, BNYS, MD(YS), is a general physician and a medical writer from Siliguri, Darjeeling.