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Remission of recently diagnosed type 2 diabetes mellitus with weight loss and exercise
Philip A Ades1, Patrick D Savage, Annis M Marney
1Divisions of Cardiology (Dr Ades and Mr Savage), Endocrinology (Dr Marney), and Nutrition and Food Sciences (Dr Harvey and Ms Evans), University of Vermont Medical Center, Burlington, Vermont.
Purpose:
To determine the rate of remission of recently diagnosed (<1 year) type 2 diabetes mellitus (T2DM) in overweight/obese individuals, with a 6-month program of weight loss and exercise.
Methods:
Subjects (N = 12) were overweight/obese (body mass index = 35.8 ± 4.3 kg/m), sedentary, and unfit ((Equation is included in full-text article.)O2peak = 20.7 ± 4.7 mL·kg·min) and recently (<1 year) diagnosed with T2DM. They were willing to participate in a lifestyle program of behavioral weight loss counseling and supervised exercise located at a cardiac rehabilitation program prior to consideration of diabetes medications. Glycated hemoglobin (HbA1c) level before and after the study intervention was the primary study outcome, along with secondary metabolic, fitness, and body composition variables.
Results:
Subjects had a baseline HbA1c of 6.5% to 8.0% (mean 6.8 ± 0.2). Subjects lost 9.7 ± 0.2 kg body weight (9%) and improved peak aerobic capacity by 18%. Two subjects withdrew for medical reasons unrelated to the lifestyle program. Eight of 10 completers (80%) went into partial T2DM remission, with the mean HbA1c decreasing from 6.8 ± 0.2% to 6.2 ± 0.3% (P < .001).
Conclusions:
For individuals with recently diagnosed T2DM willing to undertake a formal lifestyle program, 80% of study completers and 67% of our total population achieved at least a partial T2DM remission at 6 months. Further study of this intervention at the time of diagnosis of T2DM with randomized controls and longer-term followup is warranted.
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