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Lifestyle Programme Shows Possibility of Long-term Reversal of Type 2 Diabetes

The prevalence of type 2 diabetes has risen sharply during the last decade, with 425 million people worldwide now suffering from the disease, largely due to lifestyle choices, which include unhealthy eating habits. While lifestyle interventions, including nutrition, exercise and stress relief, are seen as possible solutions to stop this trend and reverse diabetes, long-term studies supporting this approach are limited.

In a study published in the BMJ Nutrition Prevention & Health journal, scientists at the Louis Bolk Institute ( in the Netherlands have evaluated the ‘Reverse Diabetes2 Now’ programme, where patients with type 2 diabetes participate in a 6-month intensive programme based on lifestyle and nutrition, with a further 18-months optional support and follow-up.

The goal of the ‘Reverse Diabetes2 Now’ programme, developed by the Dutch Foundation ‘Voeding Leeft’ (Nutrition Alive), is to help participants reverse their diabetes. The programme aims to increase knowledge about diabetes and the influence of nutrition, exercise and dealing with stress on the disease. Participants, as well as their partners, were encouraged to support each other and share their experiences in order to increase programme effectiveness. Participants also received instant biometric

feedback, by routinely measuring their blood glucose levels after meals, and by regularly measuring their waist circumference. Guidance was provided for 6 months by a support team, including a dietitian, a personal coach and a nurse who worked in collaboration with the patient’s GP.

Out of the 234 participants who completed the study, results showed that:

  • After 24 months, over two-third of the responders used less glucose-lowering medication (67%), and nearly one third 28% ceased all glucose-lowering medication (28%).
  • Notably, 71% of insulin-users at baseline (n=47 of n=66 insulin users) were no longer using insulin at 24 months.
  •  After 24 months average HbA1c levels (a measure of the average blood glucose levels over the previous weeks) did not change significantly, however more participants had Hb1Ac levels in the normal range after 24 months (53%) compared with baseline (45%).
  • After 24 months, the participants had a lower body weight, a smaller waist circumference, a lower BMI and lower triglyceride values.
  • After 24 months, the participants felt less tired, reported feeling better and had a higher quality of life score.

Lead author Dr Gerda Pot from the Louis Bolk Institute and King’s College London, said: “Addressing the underlying causes of a lifestyle disease like type 2 diabetes sounds logical but so far few studies have investigated its long-term effect. This study shows that lifestyle interventions can also be effective in the longer term for type 2 diabetes.”

Paper: Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now).

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