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Lifestyle changes are essential at all times for the management of type 2 diabetes, and prevention of progression of pre-diabetes to type 2 diabetes.
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Aim for 5-10% loss of total body weight if the patient is overweight (BMI > 30 kg/m2 OR BMI > 25 kg/m2 with waist circumference > 88 cm in women or > 102 cm in men) by developing an individualised weight management plan
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The cornerstones of lifestyle changes are:
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Healthy eating
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Physical activity
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Diabetes education and support
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Consider a green prescription and/or referral to structured education programmes (e.g. DESMOND) if available to aid above
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Consider screening for depression (e.g. PHQ-9) and referral for psychology input
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Discuss smoking cessation and reducing alcohol intake if appropriate
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Bariatric surgery should be considered as part of local DHB guidelines