Case Study
Maria, a 52-year-old woman, was recently diagnosed with type 2 diabetes (T2DM). She came to her primary care clinic feeling overwhelmed and unsure about how to manage her condition. Maria struggled with a sedentary lifestyle,
overweight and an inconsistent diet high in processed foods. Rather than starting with medications, her provider introduced her to a lifestyle medicine approach. Over six months, Maria made small but meaningful changes: walking 30 minutes daily, preparing more healthy meals and attending a local diabetes support group. At her follow-up, Maria had lost 5 kilograms, her HbA1c dropped from 7.5 gr% to 6.4 gr%, and she felt more in control of her health. This example illustrates the power of lifestyle medicine in family medicine. Below are tools that can help you support patients like Maria in making sustainable changes to manage diabetes.
1. Fostering Patient Engagement Through Motivational Interviewing
Why don’t people just do as they are told? Few conditions are associated with such a complex array of lifestyle and medical treatment issues as is diabetes. It would make everyone’s life a lot easier if people just lost some weight, did some exercise and stopped eating unhealthy food. Unfortunately, for various reasons this doesn’t seem to work very well. Partnering with patients is key to success. Using approaches like motivational interviewing (MI) which emphasizes empathy and collaboration helps patients set achievable goals for diet, exercise, and other lifestyle habits. Research shows MI improves glucose level control and helps patients stick with lifestyle changes (WR Miller et al., 2015). You can learn more about the powerful tool of Motivational Interviewing (MI) through this resource, from the Australian Family physicians site and explore additional materials available across the web. Take the opportunity to explore how MI can transform patient interactions and improve outcomes.
2. Simplifying Nutrition Guidance
Strong evidence supports the efficacy and cost-effectiveness ofnutrition therapy as a component of quality diabetes care, including its integration into the medical management of diabetes; Providing patients with clear, evidence-based nutrition plans like Mediterranean diet principals can significantly improve their blood sugar levels. Principles includes emphasizes plant-based food (vegetables, beans, nuts and seeds, fruits, and whole intact grains); fish and other seafood; olive oil as the principal source of dietary fat; dairy products (mainly yogurt and cheese) in low to moderate amounts; red meat in low frequency and amounts; wine in low to moderate amounts; and concentrated sugars or honey rarely (Alison B Evert, 2019). 3. Promoting Movement Regular physical activity (PA) is a cornerstone of diabetes care. It is now well established that participation in regular PA improves blood glucose control and can prevent or delay type 2 diabetes, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Tools like pedometers or fitness trackers can be added to motivate patients to meet daily activity goals. Aerobic and strength-training exercises are particularly effective at lowering blood sugar (Sheri R Colberg et al., 2010).
The Bottom Line
Lifestyle medicine isn’t just about managing symptoms, it’s about empowering patients to reclaim their health. By integrating these tools into primary care, providers can help patients like Maria achieve better outcomes and live
healthier lives.
References
1. Motivational interviewing in diabetes care, MP Steinberg, WR Miller
(Eds.), NY: Guilford Press (2015), New York. Book review; Clinical
Medicine Volume 16, 2016.
2. Nutrition Therapy for Adults with Diabetes or Prediabetes: A
Consensus Report; Alison B Evert. Diabetes Care, 2019; 42(5):731-
754.
3. Exercise and type 2 diabetes: the American College of Sports Medicine
and the American Diabetes Association: joint position statement; Sheri
R Colberg. Diabetes Care; 2010 Dec;33(12):147-67.
WONCA Europe Lifestyle Medicine SIG: Our Mission
To promote evidence-based lifestyle medicine by raising awareness, providing knowledge and tools, and increasing competence in using a healthy lifestyle as a tool for the prevention, management, and treatment of diseases.