Type 2 Diabetes Remission with Lifestyle Medicine

Type 2 diabetes (T2D) impacts around 10.5% of adults in the United States,1 with an increasing occurrence among younger age groups2,3 and roughly 21% of those with diabetes go undiagnosed.1

The overall expense of diabetes annually is approximated at $412.9 billion ($306 billion in direct expenses and $106.3 billion in reduced productivity).4 From both a public health and healthcare expenditure viewpoint, it is a crucial urgency to diminish the prevalence of T2D. Achieving remission, should be a primary concern.

Female physician holding a clipboard.

The Need to Reduce the Prevalence of Diabetes is Urgent

Clinicians across every specialty and practice setting encounter people daily with this debilitating yet preventable disease.
Statistic 2 01 01

$ Billion
Cost of Diabetes Annually

Statistic 1 01 01

Million U.S. Adults Have Diabetes

Statistic3 01

Lifetime chance for U.S. Hispanics
developing Diabetes

Source: ADA

Lifestyle Medicine is a Solution

Research indicates that sufficiently intensive lifestyle intervention (intensive therapeutic lifestyle change), particularly adopting a predominantly whole food, plant-based dietary pattern, exercise, and sleep, may be comparable to bariatric surgery, a commonly recognized means of effectively achieving T2D remission, but without the potential for side effects. 5,6

Furthermore, studies have shown that the approach advocated by lifestyle medicine physicians can often and reduce or eliminate the need for prescription medications, including insulin.

Research in Support Lifestyle Interventions for Treatment of T2D

The following research highlights key findings supporting the efficacy of lifestyle medicine in the the treatment of type 2 diabetes.  To read more about current projects and other research in support of the advancement of knowledge in the field of lifestyle medicine visit Lifestyle Medicine Research.

Expert Consensus: “Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission”

Expert consensus was achieved for 69 statements pertaining to diet and remission of T2D, dietary specifics and types of diets, adjuvant and alternative interventions, support, monitoring, adherence to therapy, weight loss, and payment and policy. Clinicians can use these statements to improve quality of care, inform policy and protocols, and identify areas of uncertainty.

Remission of Type 2 Diabetes After Treatment With a High-Fiber, Low-Fat, Plant-Predominant Diet Intervention: A Case Series

This case series published in the American Journal of Lifestyle Medicine, demonstrates that achieving type 2 diabetes remission is possible through a healthy diet without severe calorie restriction or liquid meal replacements. In the study, 59 patients with type 2 diabetes enrolled in a cardiac wellness program and experienced significant improvements in blood glucose control, and some even achieved full remission, by following a low-fat, whole food, plant-based diet. This highlights the significance of offering all patients the chance to make lifestyle changes as part of their routine care for treating type 2 diabetes.

Medication Deprescribing Among Patients With Type 2 Diabetes: A Qualitative Case Series of Lifestyle Medicine Practitioner Protocols

Published in Clinical Diabetes, this study provides protocols for medication deprescribing in type 2 diabetes patients following successful lifestyle medicine interventions. The study addresses the need for safe and effective deprescribing guidelines, as intensive lifestyle changes can lead to decreased blood sugar levels, potentially causing hypoglycemia if medication adjustments are not made. These protocols will be valuable resources for clinicians to reduce the reliance on prescription medications and support patients in achieving remission through evidence-based lifestyle medicine practices.

Clinical Practice Guidelines

A recently published meta-epidemiological study from ACLM (published in Advances in Nutritionsynthesizes recommendations from 78 clinical practice guidelines for major chronic conditions and general health promotion.

“…These findings support both ACLM’s dietary position statement and its recent expert consensus statement that the most effective dietary intervention for achieving T2D remission is whole, plant-based foods with minimal consumption of meat and other animal products…”

Type 2 Diabetes Remission Certificate

This certificate course equips clinicians to use intensive, evidence-based lifestyle medicine therapies to send type 2 diabetes into remission and reverse insulin resistance. Expert faculty address the scientific literature, the application of lifestyle medicine methods, practice guidelines, and monitoring standards. Physicians and eligible health professionals who complete this course will receive a Type 2 Diabetes Remission Certificate signifying specialized knowledge and competency in using lifestyle medicine to support the treatment, remission, and prevention of type 2 diabetes and insulin resistance.

ACLM’s CME/CE Diabetes and Food as Medicine Courses

Created by the foremost experts in lifestyle medicine and food as medicine, ACLM’s array of diabetes and food as medicine CME/CE courses address the need for quality, evidence-based nutrition education, missing in medical education.

Type 2 Diabetes Bill of Rights

The American College of Lifestyle Medicine (ACLM) has introduced a Type 2 Diabetes Bill of Rights aimed at empowering patients and raising awareness about their rights to evidence-based Lifestyle Medicine therapeutic approaches as a primary treatment option. ACLM believes that it is crucial to offer this treatment option at the time of diagnosis to ensure fully informed consent.

References:

1. Centers for Disease Control Prevention. National diabetes statistics report, 2020. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services. 2020
2. Lascar N, Brown J, Pattison H, Barnett AH, Bailey CJ, Bellary S. Type 2 diabetes in adolescents and young adults. The lancet Diabetes & endocrinology. 2018;6(1):69-80.10.1016/s2213-8587(17)30186-9
3. Wang L, Li X, Wang Z, et al. Trends in Prevalence of Diabetes and Control of Risk Factors in Diabetes Among US Adults, 1999-2018. Jama. 2021;326(8):1-13.10.1001/jama.2021.9883
4. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2022. Diabetes Care 2023; dci230085. https://doi.org/10.2337/dci23-0085
5. Kelly J, Karlsen M, Steinke G. Type 2 Diabetes Remission and Lifestyle Medicine: A Position Statement From the American College of Lifestyle Medicine. Am J Lifestyle Med. 2020;14(4):406-419.10.1177/1559827620930962
6. Rosenfeld RM, Kelly JH, Agarwal M, et al. Dietary Interventions to Treat Type 2 Diabetes in Adults with a Goal of Remission: An Expert Consensus Statement from the American College of Lifestyle Medicine. Am J Lifestyle Med. 2022;16(3):342-362.10.1177/15598276221087624

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