Slow and steady did the trick for Kay, who emphasized exercise and diet.(DONNA KAY)

Choosing a friend and working out together is one exercise strategy that has been shown to work for people with type 2 diabetes.

At 220 pounds, Donna Kay, 40, was overweight when she was diagnosed with diabetes in 2003. Losing weight hadn't come easy before, but Kay says this time she was ready.

"My motivation was my health crisis and a bit of fear," Kay says. "You can't hear about complications such as amputations without being just a little bit afraid."

Starting out slow and steady
She started walking for 30 minutes most days and then asked friends to join her. "Talking and looking at the Seattle skyline helps the time and miles pass," says Kay, who now lives in Prairie Village, Kan.

Kay takes metformin, Actos, and Byetta, a drug that can promote weight loss. However, she lost 40 pounds using diet and exercise before going on Byetta in November 2006.

She now mixes up her exercise routine for variety, and uses a elliptical trainer and bikes, especially in the summer. But walking with friends has certainly made a big difference.
More about exercise and weight loss

"I've lost the 45 pounds and still keep up the exercise—the benefit is measured in my hemoglobin A1C levels which have dropped from 13 to 7 percent," she says.

Cutting calories, too
Kay says she's not the sort of person who can lose weight just by exercising, so she's been conscious of what she eats, and tries to eat between 1,500 to 2,000 calories per day.

"That way," she says, "if I eat an extra cookie one day, I don't beat myself up about it."

Kay didn't make a lot of rapid changes in her lifestyle, but focused on slowly and steadily changing the little things. "I worked to make small healthy changes every day, and over the years that has added up to big improvements in my health. There are some days even now where keeping to my diet plan is challenging, but if I slip up I quickly forgive myself, analyze what went wrong and make immediate plans for improvement."

Keeping a food journal
Kay says her biggest challenge to overcome was (and sometimes still is) portion control. "There is a difference between a spoonful and a shovelful of food, and over time I have learned to be satisfied with smaller portions of food."

She also keeps a food journal for motivation. "Not every day, but occasionally. If you're trying hard you don't really want to see that you ate a cookie in your journal."

And Kay says she often reads other people's weight-loss success stories. "I read about them online and in magazines—to see what motivated someone else, or what a good idea was, like a filling soup that's low in calories, or buying a sandwich but leaving half for the next day."