Lifestyle changes are essential at all times for the management of type 2 diabetes, and prevention of progression of pre-diabetes to type 2 diabetes.
Aim for 5-10% loss of total body weight if the patient is overweight (BMI > 30 kg/m2 OR BMI > 25 kg/m2 with waist circumference > 88 cm in women or > 102 cm in men) by developing an individualised weight management plan
The cornerstones of lifestyle changes are:
Diabetes education and support
Consider a green prescription and/or referral to structured education programmes (e.g. DESMOND) if available to aid above
Consider screening for depression (e.g. PHQ-9) and referral for psychology input