Multidisciplinary Lifestyle Intervention in a Clinical Setting Leads to Remission of Type 2 Diabetes, Prediabetes,...

Trials using intensive lifestyle interventions have demonstrated remission of type 2 diabetes mellitus (T2DM), but data on real-world clinical approaches remain limited.

This retrospective analysis evaluates a 12-month clinical remission program for individuals with T2DM (glycated hemoglobin [A1C] ≥6.5%), prediabetes (A1C 5.7% to 6.4%), and early insulin resistance (A1C <5.7%, Homeostatic Model for Assessment of Insulin Resistance ≥3). Interventions included 6 nutrition counselling sessions focussed on the Mediterranean diet and a personalized aerobic/resistance training program. Metabolic parameters and body composition (bioimpedance) were assessed at baseline, 3, 6, and 12 months. The primary objective was to evaluate metabolic improvements and remission sustainability at 12 months. Only participants who finished the intervention with complete data were included in this analysis (190 of the 345 participants enrolled [55%]).

Among the 190 participants, mean reductions were as follows: body weight -4.8 kg (95% confidence interval [CI] -5.8 to -3.8, p<0.001), waist circumference -6.3 cm (95% CI -7.3 to -5.3, p<0.001), and visceral fat -1.0 L (95% CI -1.3 to -0.7, p<0.001). Participants with T2DM showed a mean A1C reduction of -0.6% (95% CI -0.9 to -0.3, p<0.001). Sustained remission at 12 months was achieved in 11 (100%) drug-naive T2DM participants, 14 (18%) with prediabetes, 17 (29%) with early insulin resistance, and 1 (2%) T2DM participant on glucose-lowering agents. Glycemic management (A1C <6.5%) was achieved in 29 (67%) T2DM participants on glucose-lowering agents, with no participant with prediabetes progressing to T2DM over the 12-month intervention.

This 12-month clinical program integrating nutrition counselling and personalized exercise significantly improved metabolic parameters and body composition. Sustained remission of T2DM was achieved in 11 drug-naive participants who completed the intervention, with no progression of prediabetes to T2DM.