The challenge of diet, exercise and lifestyle modification in the management of the obese diabetic patient

Type 2 diabetes is associated with many comorbid medical conditions includi ng obesity, neuropathy, microvascular pathology and atherosclerotic arteria l disease. Due to its complications and chronicity, reducing risk factors s uch as obesity and sedentary lifestyle through lifestyle modification is cr ucial to the long-term health of patients with type 2 diabetes. Patients mu st learn how to adopt lifelong, low-fat eating habits and regular activity patterns, with formal treatments focusing on weight loss, increased physica l activity and low-fat, low-saturated fat diets. In this article we review the efficacy of lifestyle modification programmes for obese diabetic patien ts. In addition, we discuss barriers to lifestyle changes and methods for i mproving long-term adherence. Finally, we present information on how this a pproach has been adapted to a group of Mexican Americans in the USA, a popu lation at high risk for type 2 diabetes, obesity and sedentary lifestyle.