Table 4.

Lifestyle recommendations for youth with T2D

Diabetes education should be started at the time of diagnosis and should focus on the following
Promotion of a healthy diet Use culturally sensitive and family-centered approaches to healthy eating [B] Teach families and the person with diabetes to interpret nutrition fact labels [B] Promote parental modeling of healthy eating habits, while avoiding overly restricted food intake [E] Reduce or eliminate all high calorie drinks and replace with water or calorie-free beverages [C] Promote meals eaten on schedule, in one place, preferably as a family unit, and with no other activity (television, computer, studying), and minimizing frequent snacking [E] Decrease portion sizes [B] Encourage vegetable and fiber intake to improve satiety [B] Choose roasted, grilled, boiled, or baked over fried foods [E] Limit high fat and high calorie food, processed food, and pre-packaged food [B] Maintain food and activity logs as beneficial for raising awareness of food and activity issues and for monitoring progress [E]
Increasing physical activity and limiting sedentary time Encourage youth to build up to 60 min of moderate to vigorous physical activity daily with muscle and bone strength training at least 3 days per week [B] Reduce sedentary time, including screen-time, computer-related activities, texting, and video games to less than 2 h per day [B] Promote physical activity as part of daily living such as using stairs instead of elevators, walking or bicycling to school and to shops, and doing house and yard work [E] Encourage positive reinforcement of all achievements and avoidance of shaming [E] Encourage exercise as part of family-based activities [E].
Optimizing sleep routines Encourage adequate sleep duration according to age: 9–11 h for children 5–13 years of age and 8–10 h for adolescents and young adults [B] Encourage consistent bed and wake up times and avoiding naps [E] Reduce use of electronic devices prior to going to sleep [E].
Mitigation of risky behaviors Assess use of drugs tobacco, alcohol, and vaping and refer to cessation programs if needed [E] Assess sexuality, sexual activity and offer pre-conception counseling [E].