Lifestyle modifications for type 1 diabetes encompass dietary modifications, physical activity, and other lifestyle changes.
Dietary modifications
- Carbohydrate intake: The ADA 2024 guidelines recommend providing education on the glycemic impact of carbohydrate, fat, and protein tailored to an individual's needs, insulin plan, and preferences to optimize mealtime insulin dosing . Consistent patterns of carbohydrate intake with respect to time and amount should be emphasized, considering the insulin action time when using fixed insulin doses to improve glycemia and reduce the risk for hypoglycemia
- Eating patterns: The guidelines also suggest reducing overall carbohydrate intake to improve glycemia in adult patients with diabetes, as this approach may be applied to different eating patterns meeting individual needs and preferences
- Fat intake: Patients with diabetes are advised to consider an eating plan emphasizing elements of a Mediterranean eating pattern, which is rich in monounsaturated and polyunsaturated fats and long-chain fatty acids such as fatty fish, nuts, and seeds to reduce cardiovascular disease risk and improve glucose metabolism
- Sodium intake: Sodium consumption should be limited to less than 2,300 mg/day
- General principles: Behavioral modification to achieve and maintain a minimum weight loss of 5% is recommended in all patients with overweight or obesity
Physical activity
- Aerobic activity: Most adult patients with T1DM are advised to engage in at least 150 minutes of moderate- to vigorous-intensity aerobic activity per week, spread over at least 3 days per week, with no more than 2 consecutive days without activity
- Resistance exercise: Adult patients with T1DM are advised to engage in 2-3 sessions per week of resistance exercise on nonconsecutive days
- Flexibility and balance training: Older adult patients are advised to engage in flexibility and balance training 2-3 times per week; yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength, and balance
- Sedentary behavior: Patients are advised to interrupt prolonged sitting every 30 minutes for blood glucose benefits
Other lifestyle modifications
- Hypertension management: Lifestyle interventions are advised in patients with blood pressure greater than 120/80 mmHg, consisting of weight loss when indicated, a DASH-style eating pattern (including reducing sodium and increasing potassium intake), moderation of alcohol intake, smoking cessation, and increased physical activity
In conclusion, lifestyle modifications for type 1 diabetes involve a comprehensive approach that includes dietary modifications, physical activity, and other lifestyle changes to manage the condition effectively.