Multiple Lifestyle Interventions: Impact On Metabolic Health In Patients With Prediabetes And T2D

BACKGROUND: In November 2021 the Montreal heart institute’s ÉPIC Center launched a diabetes prevention clinic that suggest a 12-months non-pharmacological intervention approach for people with PRED and T2D. We present a preliminary analysis of the evolution of metabolic health and glycemic control at 3 months. METHODS: The intervention consisted of educational and nutritional counseling, promoting a moderate carbohydrate Mediterranean diet and an 8:16 time-restricted eating, in combination with personalized exercise training prescription. Body composition measurements were taken by bioimpedance, and blood samples were drawn at 0 and 3 months. Data were compared pre and post program using an ANOVA with repeated measures at 3 months. RESULTS: 91 participants have been included in this first exploratory analysis. We observed a change in body mass loss (-2.4 kg; p < 0.01), waist circumference (-3.0 cm; p < 0.01), fat mass loss (-1.7 kg; p < 0.01), visceral fat volume (-0.6 L; p < 0.01), fasting insulin (-17.2 μmol/L; p = 0.01), HOMA-IR (-0.9; p = 0.03), and low-density lipoproteins (-0.2 mmol/L; p < 0.01) (Table 1). At 3 months 43.4% participants with PRED presented with normal glucose concentrations HbA1c < 5.7%. At 3 months, 71.1% participants with T2D have a glycemic control <6.5% (Table 2). CONCLUSIONS: Prioritizing combined lifestyle changes improves metabolic health, even to the point of achieving normal glucose concentrations measured by HbA1c after 3 months. A longer-term analysis will be needed to reach the criteria of remission, as changes in HbA1c should persist beyond 3 months.