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Article

The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study

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Research Group Microbiology & Systems Biology, TNO, Netherlands Organization for Applied Scientific Research, 3700 AJ Zeist, The Netherlands
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Research Group Child Health, TNO, Netherlands Organization for Applied Scientific Research, 2301 DA Leiden, The Netherlands
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Academic Pharmacy Stevenshof and SIR Institute for Pharmacy Practice and Policy, 2331 JE Leiden, The Netherlands
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Susanne Berbée, Diëtist, Partnership with Primark Care Centre Stevenshof, Dietician, 2331 JE Leiden, The Netherlands
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Department of Internal Medicine, Leiden University Medical Center (LUMC), 2300 RC Leiden, The Netherlands
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Author to whom correspondence should be addressed.
Academic Editor: Marleen van Baak
Nutrients 2021, 13(7), 2193; https://doi.org/10.3390/nu13072193
Received: 17 May 2021 / Revised: 16 June 2021 / Accepted: 22 June 2021 / Published: 25 June 2021
(This article belongs to the Special Issue Glucose Metabolism and Weight Management)
Although lifestyle interventions can lead to diabetes remission, it is unclear to what extent type 2 diabetes (T2D) remission alters or improves the underlying pathophysiology of the disease. Here, we assess the effects of a lifestyle intervention on T2D reversal or remission and the effects on the underlying pathology. In a Dutch primary care setting, 15 adults with an average T2D duration of 13.4 years who were (pharmacologically) treated for T2D received a diabetes subtyping (“diabetyping”) lifestyle intervention (DLI) for six months, aiming for T2D remission. T2D subtype was determined based on an OGTT. Insulin and sulphonylurea (SU) derivative treatment could be terminated for all participants. Body weight, waist/hip ratio, triglyceride levels, HbA1c, fasting, and 2h glucose were significantly improved after three and six months of intervention. Remission and reversal were achieved in two and three participants, respectively. Indices of insulin resistance and beta cell capacity improved, but never reached healthy values, resulting in unchanged T2D subtypes. Our study implies that achieving diabetes remission in individuals with a longer T2D duration is possible, but underlying pathology is only minimally affected, possibly due to an impaired beta cell function. Thus, even when T2D remission is achieved, patients need to continue adhering to lifestyle therapy. View Full-Text
Keywords: lifestyle medicine; diabetes mellitus type 2; organ insulin resistance; pancreas function; primary care; remission; diet; subtyping; pathophysiology lifestyle medicine; diabetes mellitus type 2; organ insulin resistance; pancreas function; primary care; remission; diet; subtyping; pathophysiology
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MDPI and ACS Style

de Hoogh, I.M.; Oosterman, J.E.; Otten, W.; Krijger, A.-M.; Berbée-Zadelaar, S.; Pasman, W.J.; van Ommen, B.; Pijl, H.; Wopereis, S. The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study. Nutrients 2021, 13, 2193. https://doi.org/10.3390/nu13072193

AMA Style

de Hoogh IM, Oosterman JE, Otten W, Krijger A-M, Berbée-Zadelaar S, Pasman WJ, van Ommen B, Pijl H, Wopereis S. The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study. Nutrients. 2021; 13(7):2193. https://doi.org/10.3390/nu13072193

Chicago/Turabian Style

de Hoogh, Iris M., Johanneke E. Oosterman, Wilma Otten, Anne-Margreeth Krijger, Susanne Berbée-Zadelaar, Wilrike J. Pasman, Ben van Ommen, Hanno Pijl, and Suzan Wopereis. 2021. "The Effect of a Lifestyle Intervention on Type 2 Diabetes Pathophysiology and Remission: The Stevenshof Pilot Study" Nutrients 13, no. 7: 2193. https://doi.org/10.3390/nu13072193

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