Physical activity first, medications later: new recommendations for managing diabetes

L’autorité recommande donc la mise en place d’un programme d’activité physique, ainsi qu’une modification de l’alimentation, les deux étant personnalisés en fonction du patient. simpson33/Getty Images

Type 2 diabetes, the most common, must first be managed without medication, particularly through physical activity, and only then by possible pharmaceutical treatment, according to new recommendations from the High Authority for Health (HAS).

“Lifestyle changes – physical activity, nutrition, combating a sedentary lifestyle – are a prerequisite for the possible implementation of drug treatment for hyperglycemia and must be maintained over time”, summarized the High Authority for Health (HAS) in a press release.

This "paradigm change", according to the terms of the authority which guides health policies in France, only applies to diabetes type 2.

This, which represents 90% of diabetes, affects older patients, who become less reactive to insulin. More acute, type 1 diabetes, which is due to an insulin deficiency, necessarily requires insulin therapy.

Do sports, change your diet

The new HAS recommendations are part of a context where public health policies are increasingly emphasizing the benefits of physical activity.

This one presents"numerous therapeutic benefits such as improving insulin sensitivity, reducing the risk of progression of diabetes or even cardiovascular complications", underlines the HAS.

The authority therefore recommends the implementation of a physical activity program, as well as a change in diet, both of which are personalized in function of the patient.

New strategy

"If lifestyle changes are not enough, medication is then offered to the patient" , continues the HAS.

It is therefore a new way of conceiving care, which subordinates the medicinal approach to management through lifestyle, instead of putting them on an equal footing.

"Lack of therapeutic offer"

If this strategy has a consensus among specialists, because it corresponds to the progression of knowledge in recent years, some however warn of its difficulties of application.

"Starting physical activity or changing your diet is very difficult", noted on X (ex-Twitter) the cardiologist Florian Zores, emphasizing "the lack of (therapeutic) offerings making it possible to supervise, encourage and support these changes" .