The figure presents an algorithm for adjusting the use of medications associated with hypoglycemia. At baseline, medical staff identify all participants in the lifestyle intervention who are prescribed hypoglycemic agents (e.g., insulin, sulfonylurea, repaglinide, and nateglinede) and have them monitor their blood glucose (BG) twice a day for 1 week. Participants are provided with a meter, test strips, and glucose, if needed. BG readings are reviewed with participants at the end of the week, and medications are adjusted, prior to initiating caloric restriction, using the guidelines shown.