Christopher Gudas-Cantin, Valérie Dionne, Élise Latour, Karine Lamoureux, Lyne Chevrefils, Chantal Gariepy, Marie-Hélène Morissette C, Lina Mokdad, Juliette Morin, Sarah-Maude Martin, Mathieu Gayda, Florent Besnier, Sara Desmarais, Anil Nigam, Philippe L L'Allier, Véronique Pelletier, Annie Berthiaume, Martin Juneau, Louis Bherer, Josep Iglesies-Grau
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引用次数: 0
Abstract
Introduction: Trials using intensive lifestyle interventions have demonstrated remission of type 2 diabetes mellitus (T2DM), but data on real-world clinical approaches remain limited.
Methods: This retrospective analysis evaluates a 12-month clinical remission program for individuals with T2DM (A1C ≥ 6.5%), prediabetes (A1C 5.7%-6.4%), and early insulin resistance (IR, A1C < 5.7%, HOMA-IR ≥ 3). Interventions included six nutrition counseling sessions focused on the Mediterranean diet and a personalized aerobic/resistance training program. Metabolic parameters and body composition (bioimpedance) were assessed at baseline, 3, 6, and 12 months. The primary objective was to evaluate metabolic improvements and remission sustainability at 12 months. Only participants who finished the intervention with complete data were included in this analysis (n=190 of 345 enrolled, 55% of participants).
Results: Among 190 participants, mean reductions were: body weight -4.8 kg (95% CI, -5.8 to -3.8; p<0.001), waist circumference -6.3 cm (95% CI, -7.3 to -5.3; p<0.001), and visceral fat -1.0 L (95% CI, -1.3 to -0.7; p<0.001). Participants with T2DM showed a mean A1C reduction of -0.6% (95% CI, -0.9 to -0.3; p<0.001). Sustained remission at 12 months was achieved in 11 (100%) drug-naive T2DM participants, 14 (18%) with prediabetes, 17 (29%) with early IR, and in 1 (2%) T2DM participant on glucose-lowering agents. Glycaemic control (A1C < 6.5%) was achieved in 29 (67%) T2DM participants on glucose-lowering agents, with no participant with prediabetes progressed to T2DM over the 12-month intervention.
Conclusions: This 12-month clinical program integrating nutrition counseling and personalized exercise significantly improved metabolic parameters and body composition. Sustained remission of T2DM was achieved in 11 drug-naive participants who completed the intervention, with no progression of prediabetes to T2DM.
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