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Iglesies-Grau J. Early career research Rapid Fire presentations. Presented at: American Society for Preventive Cardiology Congress on CVD Prevention; 29-31 July 2022; Louisville, Kentucky.
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LOUISVILLE, Ky. — Adults with prediabetes or type 2 diabetes who participated in a program of tailored diet and exercise programs had improvements in insulin sensitivity measures by 3 months, with some participants achieving diabetes remission.
Type 2 diabetes and prediabetes are considered “lifestyle diseases” associated with high morbidity, mortality and healthcare costs, said Josep Iglesies-Grau, MD, fellow in preventive cardiology at the Montreal Heart Institute, during a presentation at the American Society for Preventive Cardiology Congress on CVD prevention. Various lifestyle interventions can control and even reverse some cardiometabolic diseases; But such strategies are rarely implemented effectively as first-line choices, he said.
“To solve this problem, we started a free clinic that proposed to patients living with prediabetes and type 2 diabetes a 6- or 12-month multidisciplinary program to help them learn and implement healthy habits in a progressive way, ” said Iglesies-Grau during the presentation. “During follow-up, patients were offered individualized nutrition counseling sessions where a plant-based Mediterranean diet with moderate carbohydrates and intermittent fasting was suggested. They also had the option of a personalized exercise prescription and educational visits with nurses who also addressed social determinants of health.”
In a prospective, nonrandomized study, Iglesies-Grau and colleagues analyzed data from 265 adults with prediabetes (n = 81) and type 2 diabetes (n = 184), recruited from 2019 to 2020. Participants’ mean age was 68 years; 67% were men; 48% had CHD and 54% were prescribed glucose-lowering treatments. Participants completed six nutritional counseling visits and three personal physical training visits over 6 months. Participants provided blood samples and anthropometric data at baseline, 3, 6, and 12 months; glucose-lowering treatments were not changed unless necessary. Researchers defined partial remission of type 2 diabetes as HbA1c of less than 6.5% for at least 3 months; complete remission of prediabetes and type 2 diabetes was defined as an HbA1c of less than 5.7% for at least 3 months.
Researchers found that all metabolic health measures, including waist circumference, weight, BMI, glucose, insulin and HbA1c, improved during the intervention, particularly for participants with type 2 diabetes.
“Gains were achieved after 3 months and were maintained throughout the rest of the program without significant changes,” said Iglesies-Grau.
