Intensive lifestyle program in India leads type 2 diabetes participants to remission

An intensive lifestyle intervention program has shown promise in treating type 2 diabetes, leading nearly a third of its participants to achieve remission. A new study examined data from 2,384 adults with the disease who participated in the one-year online program organized by the Diabetes Clinic in India between May 2021 and August 2023.

Offered through a mobile app, the program included a personalized plant-based diet, structured physical activity, group therapy, individual psychological counseling, and medication management.

“Our research demonstrates that nearly one-third of individuals with type 2 diabetes can achieve remission through a scientifically designed, culturally tailored, and structured lifestyle intervention,” comment the authors.

“This represents the first large-scale evidence from India highlighting the potential of intensive lifestyle modification in achieving type 2 diabetes remission.”

Culturally adapted lifestyle intervention

While lifestyle interventions have shown effectiveness for diabetes management in Western populations, there has been limited data on their effectiveness in India, where genetic and lifestyle factors place the population at higher risk.

Type 2 diabetes affects more than 72 million people in India, underscore the researchers.

Overall, 744 participants (31.2%) achieved diabetes remission, which researchers defined as maintaining glycated hemoglobin (HbA1c) levels below 48 mmol/mol for at least three months without the use of glucose-lowering medications.

While lifestyle interventions have been effective for diabetes in the West, data is limited in India, where genetic and lifestyle factors place the population at higher risk.The remission group showed significantly greater improvements than the non-remission group in terms of weight (8.5% versus 5.2% reduction), body mass index (8.6% versus 5.2% reduction), HbA1c (15.3% versus 12.4% reduction), fasting insulin (26.6% versus 11.4% reduction), and insulin resistance (37.3% versus 19.7% reduction).

People under 50 years of age, with a higher BMI, no prior medication use, and a shorter duration of diabetes (under six years) were most likely to achieve remission.

The study authors note that their research is limited by its retrospective design and the absence of a control group. Additionally, there may have been selection biases because the program required a subscription and excluded participants who lacked follow-up data.

However, the authors conclude that a significant proportion of individuals with type 2 diabetes can achieve remission through a comprehensive, culturally adapted lifestyle program.

Type 2 diabetes research spotlight

The findings are available in the open-access journal PLOS One. They build on growing research in the field, including a study published last month that revealed air pollution may be a contributing factor to the “hidden cost” of worsening insulin resistance and type 2 diabetes.

Another paper published recently found that consuming one artificially sweetened soft drink each day may raise a person’s risk of developing type 2 diabetes by 38%. This threat appeared to be higher than it is for consumers of sugar-sweetened beverages, such as regular sodas, where researchers discovered the risk was 23% higher.

Meanwhile, a US study found that exposure to widespread PFAS — also known as “forever chemicals” that stay in the body — may increase the risk of developing type 2 diabetes.