Metabolic impact of a successful lifestyle intervention in patients with new onset type 2 diabetes; a pilot study

Abstract

Introduction: The aim of this pilot study was to determine the metabolic impact of intensive lifestyle intervention in patients with recent onset type 2 diabetes. Methods: 22 patients with a recent diagnosis of type 2 diabetes mellitus were enrolled in a group lifestyle intervention programme comprising an 8-month weight reduction phase followed by an 8-month maintenance phase. Clinical and metabolic measurements were made in follow-up assessments at baseline and at 4, 8 and 16 months. Results: Average weight loss (mean [95% confidence limits]) compared to baseline was -7.7 [6.6-9.7] kg, p<0.001 at 8 months representing an 8.1 (range 4.2-17.3) % reduction. After the 8-month maintenance phase, weight loss was -5.7 [4.5-6.9] kg, p<0.001, a 5.9 (range 0-11.8) % reduction compared to baseline. There were favourable improvements in fasting glucose, insulin and HbA1c but no significant changes in adipoectin, leptin or in post-glucose Glucagon-like Peptide-1 (GLP-1) levels. A 75 g oral glucose tolerance test performed at the end of the programme showed only 4 of 18 participants tested could be categorized as diabetes by WHO criteria. Conclusions: The study demonstrates the benefit of a motivational, intensive lifestyle intervention programme, delivered in a cost effective manner, achieving significant and sustained weight loss in patients with new onset type 2 diabetes.