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. 2019 May 14;2(1):43-50.
doi: 10.1136/bmjnph-2018-000012. eCollection 2019.

Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication

Gerda K Pot  1   2 , Marieke Ce Battjes-Fries  1 , Olga N Patijn  1 , Hanno Pijl  3 , Renger F Witkamp  4 , Marianne de Visser  5 , Nynke van der Zijl  6 , Maaike de Vries  7 , Peter J Voshol  1
Affiliations

Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication

Gerda K Pot et al. BMJ Nutr Prev Health. .

Abstract

Introduction: Prevalence of type 2 diabetes (T2D) is increasing rapidly and lifestyle interventions to reverse diabetes are seen as a possible solution to stop this trend. New practice-based evidence is needed to gain more insight in the actual, and above all scientific, basis for these claims.

Methods: This observational study with a pretest post-test design aimed to pilot a 6-month multicomponent outpatient group-based nutrition and lifestyle intervention programme on glycaemic control and use of glucose lowering medication in motivated T2D patients with a body mass index (BMI) >25 kg/m2 in the Netherlands (February 2015-March 2016).

Results: 74 T2D patients (56% female) aged 57.4±8.0 years with mean BMI 31.2±4.2 kg/m2 and mean waist circumference 105.4±10.2 cm were included in the study. Compared with baseline, mean HbA1c levels at 6 months were 5 mmol/mol lower (SD=10, p<0.001) and the number of participants with HbA1c levels ≤53 mmol/mol after intervention had increased (from 36% (n=26/72) to 60% (n=43/72)). At baseline, 90% of participants were taking at least one type of glucose lowering medication. At 6 months, 49% (n=35/72) of the participants had reduced their medication or eliminated it completely (13%). Secondary outcomes were significantly lower fasting glucose levels (- 1.2±2.6 mmol/L), body weight (-4.9±5.1 kg), BMI (-1.70±1.69 kg/m2) and waist circumference (-9.4±5.0 cm). Plasma lipids remained unchanged except for a decrease in triglyceride levels. Furthermore, self-reported quality of life was significantly higher while experienced fatigue and sleep problems were significantly lower.

Conclusion: This pilot study showed that a 6-month multicomponent group-based program in a routine care setting could improve glycaemic control and reduce the use of glucose lowering medication in motivated T2D diabetics. A fully scaled study is needed to confirm these results.

Keywords: lifestyle intervention; multidisciplinary; nutrition; proof of practice; reversing; type 2 diabetes.

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Conflict of interest statement

Competing interests: GKP, MCEB-F, ONP and PJV report grants from Ekhaga Foundation, grants from Voeding Leeft, during the conduct of the study; MdV reports personal fees from null, outside the submitted work; RFW reports that he is member (chair) of the scientific advisory board (Deelnemersraad) of the Voeding Leeft Foundation, for which he receives no financial or other compensation; HP and NvdZ have nothing to disclose; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1
Percentage of participants who changed glucose-lowering medication use from baseline to 6 months (n=72).
See this image and copyright information in PMC

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