II. Goals

  1. First priority: Blood Glucose control
  2. Second priority: Weight loss
    1. Do not overemphasize weight loss
    2. Maximal weight loss: 10-20 pounds
    3. Better Blood Sugar control results in weight gain
    4. DCC Trial found Blood Sugar control more important
    5. Reference
      1. Watts (1990) Arch Intern Med 150(4):803-6 [PubMed]

III. Management: Moderately restrict calories

  1. Improves Blood Sugar control
  2. Hypocaloric diet more important than weight loss
    1. Wing (1987) [PubMed]

IV. Management: Adjust Meal Schedule

  1. Break up Caloric Intake
    1. Breakfast: 20%
    2. Lunch: 40%
    3. Dinner: 40%
  2. Intersperse small snacks between meals
    1. Crackers or juice in afternoon and at bedtime
    2. Jenkins (1992) Am J Clin Nutr 55(2): 461-7 [PubMed]

V. Management: Modify fat intake

  1. Decrease overall fat intake
  2. Avoid saturated fats
  3. Switch to monounsaturated or polyunsaturated fats
    1. Eating nuts and peanut butter reduces NIDDM risk
      1. Jiang (2002) JAMA 288:2554-60 [PubMed]

VI. Management: Increase Physical Activity

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