Background: Lifestyle interventions, including very low-calorie diets and liquid meal replacements, have been shown to achieve blood glucose improvements or remission. However, intensive lifestyle intervention using solid foods without calorie restriction has not been studied.

Objective: The objective of this study is to describe changes in blood glucose, medication use and diabetes status among 50 patients who were prescribed intensive lifestyle changes to treat type 2 diabetes (T2D).

Methods: Physicians were recruited by the American College of Lifestyle Medicine to submit case histories of patients who achieved blood glucose improvements and/or remission in QuestionPro, an online survey platform.

Results: A total of 12 physicians reported on 50 patients, including 1 physician who reported on 37 patients. Mean (SD) age of patients was 66.4 (12.8) years (range 20-84), and 64% of patients were male. Primary lifestyle interventions included a whole food, plant-based diet (n=43), coaching program (n=3), ADA diet (n=2), whole food diet (n=1) and calorie restricted diet <1800kcal (n=1). No liquid meal replacements or other calorie restrictions were reported. Mean biometrics (SD) for time periods pre-intervention; 3-6 months post-; and most recent follow-up were: HbA1c 7.6 (1.5); 5.7 (0.3); 5.8 (0.4), fasting glucose 150.1 (53.4); 101.0 (30.8) ;105.2 (25.0), BMI 34.9 (14.4); 30.0 (6.0); 28.6 (5.2). A majority of patients were taking diabetes medications prior to interventions. At 3-6 months post intervention, a total of n=20 patients were not taking diabetes medications and of these, n=10 achieved either HbA1c<5.7 % or FSG<100 mg/dL. At most recent follow-up, n=21 were not taking diabetes medications and of these, n=9 achieved both HbA1c<5.7% and FSG<100 mg/dL, with n=1 for at least 12 months.

Conclusion: Patients can improve blood glucose and may achieve remission of T2D using a whole food, plant-based dietary pattern, without liquid meal replacements.


M. Karlsen: None. G. Panigrahi: None. J. Kelly: None.

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