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Lifestyle is the Key to Managing Type 2 Diabetes, According to a New Guideline
June 01, 2025
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Mounting scientific evidence demonstrates the importance of lifestyle in overall health. Our nutrition, what we eat, whether or not we move our bodies—all are instrumental in keeping us healthy and preventing diseases.
In this vein, the American College of Lifestyle Medicine, an association of health professionals aiming to reverse chronic diseases, has just published a roadmap that is the first clinical practice guideline to establish lifestyle interventions as the primary therapy for adults with prediabetes and type 2 diabetes.
It emphasizes a holistic approach to diabetes that seeks to manage the disease not only with drugs but also with concrete behavior change interventions.
The group that developed the guide included 20 members representing the key areas of change: consumers, specialized nursing, cardiology, clinical pharmacology, behavioral medicine, endocrinology, family medicine, lifestyle medicine, nutrition and dietetics, health education, health and wellness coaching, sleep medicine, sports medicine, and obesity medicine.
Recommendation strength was based on the evidence supporting the key actions as well as a comparison of associated benefits, such as cost savings from disease prevention and management compared to the increased costs of disease treatment.
Multiple literature searches, done by an information specialist, identified 8 relevant guidelines, 118 relevant systematic reviews, and 112 randomized clinical trials.
Based on the collected evidence, the guideline emphasizes the following therapeutic actions:
Maintain a plant‑predominant diet
Experts say that dietary patterns that prioritize whole foods and vegetables should be reinforced, as they help counteract insulin resistance and metabolic dysfunction.
Plant‑based or plant‑predominant diets include not only fruits and vegetables but also nuts, seeds, oils, whole grains, and legumes. In case the patient is concerned, it should be clarified that this does not mean that they will become vegetarian or vegan and will never be able to eat meat or dairy products again. It simply means shifting the balance of products.
Tobacco and alcohol should also be avoided, as they are metabolic modulators and impact glucose control.
Do exercises that help with blood sugar control
Regular physical activity is essential for controlling glucose levels in all people, but especially those living with diabetes. Exercise helps reduce blood sugar by increasing insulin sensitivity and improving glucose absorption by muscles.
A combination of aerobic exercise, strength training, and alternating periods of sitting with light movements can be beneficial.
Sleep well, 7 to 9 hours a night. Sleep helps regulate glucose metabolism
Every night, whether or not you sleep, blood sugar levels increase as part of the natural circadian rhythm. Blood sugar fluctuations that occur during the night and sleep are normal and are not a cause for concern for most healthy people.
But sleep also plays an important role in maintaining healthy blood sugar levels. In recent decades, the average number of hours of sleep a night appears to have decreased.
Reduced sleep may have contributed to the rise in obesity and diabetes that occurred during the same period. These trends are interrelated: obesity and diabetes are affected by blood sugar levels, and blood sugar levels also affect obesity and diabetes. As a result, blood sugar could be one of the factors that influence weight loss and sleep.
Practice effective stress management, the foundation of a healthy mind and body
A solid body of research has shown that stress impacts overall health. In diabetes, being mentally stressed can elevate glucose levels.
When we are stressed, our bodies can enter “flight or fight” mode and release hormones like adrenaline. These hormones can speed up our heart rate and tense up our muscles as they prepare us to face a difficult situation.
But they also tell our livers to release extra sugar into the blood, which can cause glucose spikes. If we are in a state of constant stress, this can affect our body’s ability to manage glucose effectively over time.
Another key lifestyle action for glucose control is the social connectedness and support necessary to maintain a healthy mind and body—in other words, to be able to accomplish all the other recommended actions.
The health professionals who developed the new type 2 diabetes management guideline believe that there is a need for a paradigm shift in care for this disease. They recommend these actions to kick off this strategy:
- Make lifestyle medicine the first‑line treatment, before pharmacotherapy.
- Provide clinical professionals with standardized protocols for evaluating, prescribing, and following up on lifestyle interventions.
- Focus on reversing diabetes by tackling root causes instead of managing symptoms.
This story was produced using content from original studies or reports, as well as other medical research and health and public health sources cited in links throughout the article.