Lifestyle intervention have proved to reduce incidence of diabetes, whether or not exist an impaired glucose tolerance (1, 2). Moreover, changes in diet and exercise have shown a positive impact on HbA1c in patients with Diabetes Type 2, as was found in a meta analysis of Chen et al where a significant standardize difference in means of HbA1c (-0.37 P=0.0001)was evident(3).Furthermore, lifestyle interventions have a well known effect over lipid profile, markers of inflammation and a positive impact on body composition, that is, an increase in lean mass and a reduction of fat mass(1).
All of the above makes a lifestyle behavioural intervention a successful management strategy for patient with Diabetes, not only because of the impact on glycaemic control but for the potential improvement on quality of life(4).However, emphasis on lifestyle intervention in clinical practice is not the expected, only 42% of primary care providers discuss lifestyle intervention with patients during clinical visits(5), which is as a lost opportunity to promote self-care behaviours that could make an impact on outcomes at a minimal
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Treatment goals should take into account patients preferences, as well as social situation, cultural factors, diabetes complications and life expectancy (4, 12, 13). Considering the above, good communication with primary health care provider could facilitate empowerment, which is a process that patients need to engage in for themselves(13, 14), but it is facilitated primarily by physicians, because of that, it is necessary that general physicians feel comfortable to encourage patients toward healthy lifestyle changes and to seek support from other health care professionals such dietitians, physiotherapists, psychologist and nurses trained in diabetes