Diabetes Self-Management: Facilitating Lifestyle Change

Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. During office visits, physicians should assess and gradually encourage patients' readiness to work toward change. Addressing patients' conviction and confidence can be effective in moving them toward action. Long-term goals are best separated into highly specific short-term outcome goals and achievable behavior targets. Lifestyle goals and targets should be tailored to patients' preferences and progress while building confidence in small steps. Screening for diabetes-related attitudes, expectations, and quality of life, and addressing psychosocial factors, both favorable and unfavorable, can facilitate the likelihood of success. Follow-up contact with patients helps maintain and expand progress by reviewing self-monitored goals, targets, and achievements; finding opportunities to encourage and empower; reviewing slips, triggers, and obstacles; and negotiating further customization of the plan.