Title
The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study
Author
de Hoogh, I.M.
Oosterman, J.E.
Otten, W.
Krijger, A.M.
Berbée-Zadelaar, S.
Pasman, W.J.
van Ommen, B.
Pijl, H.
Wopereis, S.
Publication year
2021
Abstract
Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.4 years who were (pharmacologically) treated for T2D received a diabetes subtyping ("diabetyping") lifestyle intervention (DLI) for six months, aiming for T2D remission. T2D subtype was determined based on an OGTT. Insulin and sulphonylurea (SU) derivative treatment could be terminated for all participants. Body weight, waist/hip ratio, triglyceride levels, HbA1c, fasting, and 2h glucose were significantly improved after three and six months of intervention. Remission and reversal were achieved in two and three participants, respectively. Indices of insulin resistance and beta cell capacity improved, but never reached healthy values, resulting in unchanged T2D subtypes. Our study implies that achieving diabetes remission in individuals with a longer T2D duration is possible, but underlying pathology is only minimally affected, possibly due to an impaired beta cell function. Thus, even when T2D remission is achieved, patients need to continue adhering to lifestyle therapy.
Subject
Diabetes mellitus type 2
Diet
Lifestyle medicine
Organ insulin resistance
Pancreas function
Pathophysiology
Primary care
Remission
Subtyping
To reference this document use:
http://resolver.tudelft.nl/uuid:bf2b776f-6822-4a76-b520-847a61d8c35f
DOI
https://doi.org/10.3390/nu13072193
TNO identifier
957163
Source
Nutrients, 13 (13)
Document type
article