Characterization of individuals achieving type 2 diabetes remission in real-world settings: bridging clinical evidence and patient experiences.

Abstract

The objectives of the study were to (1) describe characteristics and lifestyle factors of individuals who have achieved type 2 diabetes (T2D) remission (sub-diabetes glucose levels without glucose-lowering medications for ≥3 months) through changes to diet and exercise behaviour in real-world settings; (2) investigate continuous glucose monitoring (CGM) profiles of these individuals and explore how dietary pattern may influence glucose regulation metrics. This cross-sectional study recruited individuals living with T2D who achieved remission via changes to diet or exercise behaviours. Various questionnaires were used to assess overall health and participants wore a blinded CGM for 14 days to assess glucose profiles and filled out 3-day food records. A total of 21 adults (57 ± 8 years of age) who were recently diagnosed with T2D (4 ± 3 years) with a A1c of 5.7 ± 0.4% volunteered to participate. Participants achieved remission through various means (e.g., combination of diet and exercxise/physical activity) and self-reported following different diets, including 52% following a low-carbohydrate or very low carbohydrate diet, 14% following a "ketovore/carnivore" diet, 10% using a meal replacement diet, 5% following Weight Watcher's diet, and 19% no defined dietary pattern. The 24 h average CGM glucose value was 5.0 [4.8-5.6] mmol/L (median [IQR]) with 92 [85-97]% of time spent in range (between 4.0 and 9.9 mmol/L). The 24 h average CGM glucose (r = 0.692; P = 0.001) and A1c (r = 0.470; P = 0.049) were correlated with the daily percentage of energy intake from carbohydrate. Remission of T2D appears achievable through various means, including adoption of different dietary approaches and a more active lifestyle underpinning the importance of a patient-centred care.