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The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study

Iris M de Hoogh1, Johanneke E Oosterman1, Wilma Otten2

  • 1Research Group Microbiology & Systems Biology, TNO, Netherlands Organization for Applied Scientific Research, 3700 AJ Zeist, The Netherlands.

Nutrients
|July 2, 2021
PubMed

Insights

Lifestyle interventions can help achieve type 2 diabetes (T2D) remission, even in long-standing cases. However, the underlying disease pathology is only minimally improved, highlighting the need for continued lifestyle adherence.

Area of Science:

  • Metabolic diseases
  • Endocrinology
  • Primary care research

Background:

  • Lifestyle interventions show promise for type 2 diabetes (T2D) remission.
  • The impact of T2D remission on underlying disease pathophysiology remains unclear.
  • Understanding these effects is crucial for long-term diabetes management.

Purpose of the Study:

  • To assess the effects of a lifestyle intervention on T2D remission and reversal.
  • To evaluate the impact of remission on the underlying pathophysiology of T2D.
  • To determine if T2D subtypes change with remission.

Main Methods:

  • A six-month "diabetyping" lifestyle intervention (DLI) was applied to 15 adults with T2D in Dutch primary care.
  • Participants underwent diabetes subtyping based on an oral glucose tolerance test (OGTT).
  • Medication (insulin, sulfonylurea derivatives) was discontinued; various metabolic markers were monitored.

Main Results:

  • Significant improvements in body weight, waist/hip ratio, triglycerides, HbA1c, fasting, and 2h glucose were observed.
  • T2D remission and reversal were achieved in 2 and 3 participants, respectively.
  • Insulin resistance and beta cell capacity improved but did not normalize, and T2D subtypes remained unchanged.

Conclusions:

  • Diabetes remission is achievable in individuals with longer T2D duration through lifestyle interventions.
  • Underlying T2D pathology is minimally affected, potentially due to persistent beta cell dysfunction.
  • Continued adherence to lifestyle therapy is essential even after achieving diabetes remission.
Keywords:
diabetes mellitus type 2dietlifestyle medicineorgan insulin resistancepancreas functionpathophysiologyprimary careremissionsubtyping

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