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Most patients with diabetes will need to move from lifestyle management alone to lifestyle management combined with pharmacological therapy to reach glycemictargets. These support services complement and augment the primary care clinician’s role in endorsing the importance of lifestyle behaviors at each visit.
4 Most health care systems have dietitians and certified diabetes educators for such patient support. Formal diabetes education about diet, physical activity, blood glucose monitoring, pharmacotherapy-related issues, and screening for complications is imperative both at the outset and at regular follow-up intervals. All strategies to improve blood glucose control will involve patient engagement in diabetes self-management and lifestyle change.
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