Nutrition management and physical activity as treatments for diabetes

Diabetes is essentially a self-management disease in which patients must le arn to integrate blood glucose monitoring with nutrition management and phy sical activity and, if needed, oral agents or insulin. This almost always r equires behavior change. The American Diabetes Association diet is no longe r a meaningful prescription, because recommendations are now based on indiv idualized nutrition assessment and treatment goals. Physical activity recom mendations, as an adjunct to nutrition management, should also be individua lized. Using a team approach, focusing on individualization of nutrition ma nagement and physical activity, applying behavior change concepts, and prov iding frequent follow-up can improve self-management and result in improved metabolic control. Primary care practitioners are in a unique position to oversee this process.