Type 2 diabetes remission 1 year after an intensive lifestyle intervention

A secondary analysis of a randomized clinical trial

Mathias Ried-Larsen*, Mette Y. Johansen, Christopher S. MacDonald, Katrine B. Hansen, Robin Christensen, Anne Sophie Wedell-Neergaard, Nanna Skytt Pilmark, Henning Langberg, Allan A. Vaag, Bente K. Pedersen, Kristian Karstoft

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

17 Downloads (Pure)

Abstract

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/m2. 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.

Original languageEnglish
JournalDiabetes, Obesity and Metabolism
Volume21
Issue number10
Pages (from-to)2257-2266
ISSN1462-8902
DOIs
Publication statusPublished - Oct 2019

Fingerprint

Type 2 Diabetes Mellitus
Randomized Controlled Trials
Odds Ratio
Confidence Intervals
Resistance Training
Glycosylated Hemoglobin A
Body Mass Index
Outcome Assessment (Health Care)

Keywords

  • clinical trial
  • dietary intervention
  • exercise intervention
  • type 2 diabetes
  • weight control

Cite this

Ried-Larsen, M., Johansen, M. Y., MacDonald, C. S., Hansen, K. B., Christensen, R., Wedell-Neergaard, A. S., ... Karstoft, K. (2019). Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial. Diabetes, Obesity and Metabolism, 21(10), 2257-2266. https://doi.org/10.1111/dom.13802
Ried-Larsen, Mathias ; Johansen, Mette Y. ; MacDonald, Christopher S. ; Hansen, Katrine B. ; Christensen, Robin ; Wedell-Neergaard, Anne Sophie ; Pilmark, Nanna Skytt ; Langberg, Henning ; Vaag, Allan A. ; Pedersen, Bente K. ; Karstoft, Kristian. / Type 2 diabetes remission 1 year after an intensive lifestyle intervention : A secondary analysis of a randomized clinical trial. In: Diabetes, Obesity and Metabolism. 2019 ; Vol. 21, No. 10. pp. 2257-2266.
@article{6d2ed1c9a1d14668800f7426bf967ea2,
title = "Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial",
abstract = "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/m2. 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.",
keywords = "clinical trial, dietary intervention, exercise intervention, type 2 diabetes, weight control",
author = "Mathias Ried-Larsen and Johansen, {Mette Y.} and MacDonald, {Christopher S.} and Hansen, {Katrine B.} and Robin Christensen and Wedell-Neergaard, {Anne Sophie} and Pilmark, {Nanna Skytt} and Henning Langberg and Vaag, {Allan A.} and Pedersen, {Bente K.} and Kristian Karstoft",
year = "2019",
month = "10",
doi = "10.1111/dom.13802",
language = "English",
volume = "21",
pages = "2257--2266",
journal = "Diabetes, Obesity and Metabolism",
issn = "1462-8902",
publisher = "Wiley-Blackwell",
number = "10",

}

Ried-Larsen, M, Johansen, MY, MacDonald, CS, Hansen, KB, Christensen, R, Wedell-Neergaard, AS, Pilmark, NS, Langberg, H, Vaag, AA, Pedersen, BK & Karstoft, K 2019, 'Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial', Diabetes, Obesity and Metabolism, vol. 21, no. 10, pp. 2257-2266. https://doi.org/10.1111/dom.13802

Type 2 diabetes remission 1 year after an intensive lifestyle intervention : A secondary analysis of a randomized clinical trial. / Ried-Larsen, Mathias; Johansen, Mette Y.; MacDonald, Christopher S.; Hansen, Katrine B.; Christensen, Robin; Wedell-Neergaard, Anne Sophie; Pilmark, Nanna Skytt; Langberg, Henning; Vaag, Allan A.; Pedersen, Bente K.; Karstoft, Kristian.

In: Diabetes, Obesity and Metabolism, Vol. 21, No. 10, 10.2019, p. 2257-2266.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Type 2 diabetes remission 1 year after an intensive lifestyle intervention

T2 - A secondary analysis of a randomized clinical trial

AU - Ried-Larsen, Mathias

AU - Johansen, Mette Y.

AU - MacDonald, Christopher S.

AU - Hansen, Katrine B.

AU - Christensen, Robin

AU - Wedell-Neergaard, Anne Sophie

AU - Pilmark, Nanna Skytt

AU - Langberg, Henning

AU - Vaag, Allan A.

AU - Pedersen, Bente K.

AU - Karstoft, Kristian

PY - 2019/10

Y1 - 2019/10

N2 - 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/m2. 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.

AB - 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/m2. 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.

KW - clinical trial

KW - dietary intervention

KW - exercise intervention

KW - type 2 diabetes

KW - weight control

U2 - 10.1111/dom.13802

DO - 10.1111/dom.13802

M3 - Journal article

VL - 21

SP - 2257

EP - 2266

JO - Diabetes, Obesity and Metabolism

JF - Diabetes, Obesity and Metabolism

SN - 1462-8902

IS - 10

ER -