Background and Aim: Type 2 diabetes (T2D) remission is widely reported across the world. However, there are no large-scale cohort studies that report the effectiveness of lifestyle intervention on T2D remission, especially in Indian population. The study aimed to evaluate the effectiveness of a one-year lifestyle modification program-Holistic Transformation Program (HTP) on T2D remission in Indian population.

Materials and methods: Patients with diagnosed T2D (>18 years of age) were recruited in a one-year intensive lifestyle modification program at the Freedom from Diabetes Clinic, Pune (India) between April and December 2021. The intervention included a customized vegan diet, exercises, stress management support, and medical management. Anthropometric and biochemical parameters were assessed with scheduled consults every 3 months. Remission was defined as HbA1c<48 mmol/mol for a minimum of 3 months without the use of antidiabetic medication.

Results: The mean age and duration of diabetes were 52.0±10.6 years and 10.3±7.9 years, respectively (n=2764). Post-intervention, median weight, and HbA1c decreased significantly (weight-71 kgs to 67 kgs, p<0.01; HbA1c-7.5% to 6.6%) (p<0.05). Remission was seen in 837 (30.3%) patients. Significantly higher remission was seen in those with >15 kg weight loss and with diabetes duration of <10 years (p<0.05). Remission was highest in those who never started medication (with HbA1c>48 mmol/mol at baseline) (79%) followed by those only on oral hypoglycemic agents (31.7%). Improvement in HbA1c and weight loss were similar between patients on external insulin and/or OHA (p>0.1) indicating efficacy of the intervention irrespective of the medicine status at baseline.

Conclusion: Our findings suggest that customized lifestyle intervention is beneficial in achieving T2D remission in Indian population. A one-year post-intervention follow-up is underway to understand the long-term effects of the intervention.

Disclosure

P. Tripathi: Board Member; Freedom from Diabetes Clinic. N.S. Kadam: Research Support; Freedom from Diabetes Clinic. B. Sharma: Research Support; Freedom From Diabetes clinic. A.R. Vyawahare: Research Support; Freedom From Diabetes. M.H. Ganla: Employee; Freedom from Diabetes Clinic. M. Das Biswas: Employee; Freedom from Diabetes Clinic. B.D. Saboo: None.

© 2023 by the American Diabetes Association
2023
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