To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus (T2DM).
Changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term.The evidence supporting the role of exercise, medical nutrition therapy, glucose monitoring, and antiobesity measures including pharmacotherapy and bariatric surgery.The optimum dietary macronutrient composition remains a subject of interest; however, several studies have shown that dietary measures are effective in weight reduction irrespective of the composition (low fat vs low carbohydrate), provided there is adequate energy restriction, reduction in saturated fat to less than 7%, and adequate provision of dietary fiber.Although low-fat and low-carbohydrate diets are both effective in producing weight loss, their effect on lipid profile may differ. Low-carbohydrate diet may yield greater reduction in triglyceride with higher improvement in high-density lipoprotein, but with higher low-density lipoprotein levels in comparison to low-fat diet.
Lower consumption of total and saturated fat and processed foods, and higher consumption of fibers, whole grains, fruits, and vegetables have been shown to improve glycemic control in patients with diabetes. In clinical trials, nut consumption increases satiety, have a neutral effect on glucose and insulin, and a beneficial effect on lipid profile.Artificial sweeteners may cause diarrhea; otherwise, they are safe when used according to Food and Drug Administration (FDA) recommendation. Although diabetic subjects may have increased oxidative stress, placebo-controlled trials have not demonstrated any clear benefit attributable to antioxidant supplementation.