Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial

AIM: To investigate whether an intensive lifestyle intervention induces partial or complete type 2 diabetes (T2D) remission. MATERIALS AND METHODS: In a secondary analysis of a randomized, assessor‐blinded, single‐centre trial, people with non‐insulin‐dependent T2D (duration <10 years), were randomly assigned (2:1, stratified by sex, from April 2015 to August 2016) to a lifestyle intervention group (n = 64) or a standard care group (n = 34). The primary outcome was partial or complete T2D remission, defined as non‐diabetic glycaemia with no glucose‐lowering medication at the outcome assessments at both 12 and 24 months from baseline. All participants received standard care, with standardized, blinded, target‐driven medical therapy during the initial 12 months. The lifestyle intervention included 5‐ to 6‐weekly aerobic and combined aerobic and strength training sessions (30‐60 minutes) and individual dietary plans aiming for body mass index ≤25 kg/m(2). No intervention was provided during the 12‐month follow‐up period. RESULTS: Of the 98 randomized participants, 93 completed follow‐up (mean [SD] age 54.6 [8.9] years; 46 women [43%], mean [SD] baseline glycated haemoglobin 49.3 [9.3] mmol/mol). At follow‐up, 23% of participants (n = 14) in the intervention and 7% (n = 2) in the standard care group met the criteria for any T2D remission (odds ratio [OR] 4.4, 95% confidence interval [CI] 0.8‐21.4]; P = 0.08). Assuming participants lost to follow‐up (n = 5) had relapsed, the OR for T2D remission was 4.4 (95% CI 1.0–19.8; P = 0.048). CONCLUSIONS: The statistically nonsignificant threefold increased remission rate of T2D in the lifestyle intervention group calls for further large‐scale studies to understand how to implement sustainable lifestyle interventions among people with T2D.