Lifestyle Therapy for the Treatment of Youth with Type 2 Diabetes

# The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Type 2 diabetes (T2D) in youth is a relatively novel condition facing paediatric health care providers. Few exper-imental trials exist to guide clinical management in this pop-ulation. Supporting and prescribing modifiable lifestyle be-haviours is cornerstone in the management of T2D in adults. Clinical trials in obese adolescents suggest that intensive lifestyle interventions that include both dietary changes and increased physical activity elicit clinically meaningful reduc-tions in weight and improve cardiovascular risk profiles. Observational studies in youth with T2D suggest that better diet quality and increased physical activity are associated with better metabolic control; however, the limited experimental data available does not support these observations. Trials evaluating lifestyle monotherapy for the treatment of hyperglycaemia in youth with T2D do not exist, and the only study evaluating combined lifestyle and pharmacologic ther-apy did not show additional benefit over pharmacologic treat-ment with metformin alone. Physiological and psychosocial differences between youth and adults with T2D likely con-tribute to the differences in the effectiveness of lifestyle ther-apy for improving glycaemic control. The current review describes these topics in detail and provides recommendations for paediatric health care providers for the promotion of lifestyle therapy for the management of hyperglycaemia and cardiovascular risk factors for youth with T2DM