2008 Clinical Practice Guidelines - Canadian Diabetes Association

2008 CLINICAL PRACTICE GUIDELINES
S80
RECOMMENDATIONS
1.A comprehensive healthy lifestyle intervention program
(including a hypocaloric, nutritionally balanced diet, regular
physical activity or exercise, and behavioural modification
techniques) for overweight and obese people
with, or at risk for diabetes, should be implemented to
achieve and maintain a healthy body weight [Grade D,
Consensus]. Members of the healthcare team should
consider using a structured approach to providing
advice and feedback on physical activity, healthy eating
habits and weight loss [Grade C, Level 3 (31-34)].
2. In overweight or obese adults with type 2 diabetes, a
pharmacologic agent such as orlistat [Grade A, Level 1A
(26)] or sibutramine [Grade B, Level 2 (37)] should be
considered as an adjunct to lifestyle modifications to
facilitate weight loss and improve glycemic control.
3.Adults with class III obesity (BMI ≥40.0 kg/m 2 ) or class II
obesity (BMI 35.0 to 39.9 kg/m 2 ) with other comorbidities
may be considered for bariatric surgery when other
lifestyle interventions are inadequate in achieving weight
goals [Grade C, Level 3 (43)].
OTHER RELEVANT GUIDELINES
Physical Activity and Diabetes, p. S37
Nutrition Therapy, p. S40
RELATED WEBSITES
Health Canada. Canadian Guidelines for Body Weight
Classification in Adults. Quick Reference for Professionals.
Available at: http://www.hc-sc.gc.ca/fn-an/alt_formats/
hpfb-dgpsa/pdf/nutrition/cg_quick_ref-ldc_rapide_ref_e.pdf.
Accessed September 1, 2008.
OBESITY CANADA GUIDELINES
2006 Canadian Clinical Practice Guidelines on the
Management and Prevention of Obesity in Adults and
Children. Available at: http://www.cmaj.ca/cgi/content/
full/176/8/S1/DC1. Accessed September 1, 2008.
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