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