Management of Existing Disease

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It is well recognized that OW/OB complicates the management of type 2 diabetes via increased insulin resistance and blood-glucose levels (16). For persons with type 2 diabetes who are OW/OB, targeting efforts to reach a healthy BMI (ideally < 25 kg/m2) is the most important goal of lifestyle interventions (17, 18). When combined with increased activity, weight loss can dramatically enhance insulin sensitivity and glycemic control (8). Improvements occur in insulin action and blood-glucose concentrations, and required doses of diabetes medications may be reduced. Reductions in fasting glucose levels correspond directly to the amount of weight reduction (8,19). Alternatively, if excess weight is not reduced, glycemic control is likely to deteriorate over time, in as little as 12 months (7).

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