Lifestyle prescriptions for diabetes management in primary care: a narrative review

Diabetes mellitus is a complex chronic disease with a rapidly increasing global prevalence. For this condition, non-pharmacological lifestyle modification is as important as pharmacological treatment. This review aims to comprehensively examine lifestyle prescriptions for diabetes across multiple domains to integrate current insights and understanding. In medical nutrition therapy, which is central to diabetes treatment and management, excessive carbohydrate intake should be restricted, while individualized consumption of high-quality carbohydrates, protein, and unsaturated fatty acids is recommended. Intake of added sugars and sodium should also be limited. Physical activity should similarly be tailored to the individual, with a combination of aerobic exercise and resistance training recommended. Careful consideration of hypoglycemia risk and diabetes complications is essential. Additional strategies include limitations on uninterrupted sedentary time to less than 30 minutes, maintenance of a healthy body weight, smoking cessation, alcohol abstinence, sleep health improvements, and attention to psychosocial care. In primary care settings, patient-specific assessment, multidisciplinary lifestyle prescriptions, and education to support behavior modification are expected to play a pivotal role in the treatment and management of diabetes.