"The groundwork of all happiness is health." - Leigh Hunt

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch.

Much research supports the common sense notion that a healthy lifestyle can prevent or treat many diseases. A weight loss plan high in fruits, vegetables, whole grains, and plant protein and low in processed carbohydrates, added sugars, and saturated fat; regular physical activity; And emotional well-being are powerful therapies that may prevent or replace the necessity for a lot of prescribed drugs.

Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes.

Here's one other study that currently supports extreme lifestyle interventions for diabetes. It seems that the authors of the study underestimate their results, which, frankly, surprised me. I'm excited to report that this study strongly confirms what I even have often observed in medicine over the past 15 years: the best way we live and the things we put into our mouths have I put it, it might be more powerful than many pills. legitimate

Basically, the study authors recruited 98 individuals with type 2 (adult-onset) diabetes who were all the identical. they'd diabetes for lower than 10 years and their blood sugar was not completely uncontrolled (HbA1c* lower than 9%); They weren't on insulin; All of them had a body mass index between 25 and 40 (meaning they were chubby).

They divided the people into two groups for a 12 months. Both groups remained on their regular medications. The standard care group (34 people) received basic counseling and education in type 2 diabetes, including lifestyle advice from a nurse firstly of the study and each three months.

A second group (64 people) also received a more intensive lifestyle intervention:

  • Five to 6 exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, two to a few sessions of weight training.
  • Individual nutrition plan with dietary counseling, including calorie restriction for the primary 4 months
  • A smartwatch/step counter and encouragement to be physically energetic in your free time (with a goal of a minimum of 10,000 steps per day).

Overall blood sugar control was barely higher in the life-style group after one 12 months, but the true kicker was this: 73% of the life-style participants were in a position to reduce their diabetes medication doses, compared to plain care. in comparison with only 26% of the group. And, greater than half of Lifestyle participants are in a position to stop their medications safely! In fact, 44% of the usual care group needed to take their very own medication. Increased During the study, in comparison with just 11 percent in the life-style group.

*HbA1C Abbreviation for hemoglobin A1c, which is formed by the binding of glucose (blood sugar) to hemoglobin (a protein in red blood cells). The HbA1c test is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% signifies that blood sugar has been in an excellent range for the past few months.

Other improvements in health measurement

In addition, the life-style group enjoyed significant improvements in all of its measurements: weight (13.2 kilos lost in comparison with 4.4 kilos), BMI (31 to 29, in comparison with 32.5 to 32), and abdominal fat. (2 lbs.). Lost, as in comparison with 0.2 lbs, with a rise in lean body mass (i.e. muscle). A 3rd of the life-style group lost greater than 10% of their body weight, compared with 3% of the usual care group. And the lifestylers also experienced significant improvements of their physical fitness, as measured by a flowery machine that measures the body's oxygen uptake during strenuous exercise.

The study's authors seem to emphasise that lifestyle improved blood sugar marginally higher than standard care at 12 months. What was incredibly surprising, was the blood sugar trend all year long. At six months, the life-style group's HbA1c levels dropped significantly, from 6.6% to six.2%, in comparison with the usual care group's HbA1c. Increased From 6.7% to six.9%. At 12 months, each groups were near where they began, with the life-style group doing barely higher than the usual care group at 6.6 percent versus 6.3 percent.

Why is that this?

There are two possible reasons for this. One was that the life-style group had only fully supervised exercise and dietary counseling sessions (including calorie restriction) for the primary 4 months, and thereafter, the supervision was steadily reduced, and consequently People were less prone to follow this system. In fact, the article shows that participation in exercise and dietary counseling sessions decreased over the 12 months.

Another factor is that participants' diabetes medications were being adjusted throughout the study for health and safety reasons. If the HbA1c fell below 6.5%, their medication was reduced, and if it remained that low or decreased, the medication was stopped. Likewise, if HbA1c went above 7.5%, the medication was increased. The lifestyle group had more episodes of low blood sugar than standard care, and while this will likely be alarming, it also indicates that lifestyle participants needed less medication over time. was

Therefore, it is cheap to take a position that if the monitoring of exercise and dietary sessions had been continuous throughout the study, and if the medication had not been continuously adjusted, the outcomes would have shown an excellent greater improvement for those in the life-style group.

And it jibes with previous studies taking a look at lifestyle interventions to forestall and treat heart disease. So much evidence has amassed to support lifestyle interventions as a really effective treatment, that major insurance carriers will now cover such programs.

I hope patients realize that lifestyle changes are only nearly as good, and sometimes even higher, than prescribed drugs. Primary care physicians have to help them do that.


The potential of lifestyle medicine to change the world of the chronic disease epidemic: from the cell to the community. International Journal of Clinical PracticeOctober 2014.

A population approach to improving diet, physical activity, and smoking habits: a scientific statement from the American Heart Association.. circulationAugust 2012.

Head-to-head comparison of intensive lifestyle intervention (U-TURN) versus conventional multifactorial care in patients with type 2 diabetes: protocol and rationale for an assessor-blind, parallel-group, randomized trial.. BMJDecember 2015.

Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JamaAugust 2017.

Effects of lifestyle modification programs on cardiac risk factors. PLoS OneDecember 2014.