Lifestyle based remission in type 2 diabetes: implications for clinical practice

dc.contributor.authorWhitehill, Derek
dc.date.accessioned2019-10-21T19:09:49Z
dc.date.available2019-10-21T19:09:49Z
dc.date.issued2019
dc.date.submitted2019-10-21T19:09:49Zen
dc.description.abstractType 2 diabetes is often thought of as a chronic and progressive disease. This paper evaluates three emerging methods of achieving remission of type 2 diabetes through dietary lifestyle interventions. These strategies have also highlighted the need for medication deprescribing guidelines. This paper reviews the efficacy, safety, adverse effects and implementation of very low energy diets, low-carbohydrate diets and intermittent fasting on type 2 diabetes. The very-low energy based on The Diabetes Remission Clinical Trial (DiRECT) demonstrated remission in 46% of participants after one year, with 74% taken off all anti-hyperglycemics. Low carbohydrate intake (<30g per day) in the Virta Health study demonstrated 83% of participants continuing to the one-year mark. Average HbA1c decreasing from 7.6 to 6.3 %, with an average weight loss of 13 kg. 94% of them reduced or eliminated insulin use. Intermittent fasting has been shown in literature to promote weight loss and glycemic control since the 1970’s, however recent case studies show patients removed of 70+ units of insulin daily in 5-18 days. The conclusion is while there is not yet a consensus best way to achieve remission of type 2 diabetes, nor a guarantee that it will work for all patients, there may need not be one. Practitioners should have the knowledge to discuss a variety of potential options with patients and assist them with the medication deprescribing that may be necessary.en_US
dc.identifier.urihttp://hdl.handle.net/1993/34343
dc.rightsopen accessen_US
dc.subjectDiabetes remissionen_US
dc.subjectvery low energy dieten_US
dc.subjectDiRECT Trialen_US
dc.subjectlow carbohydrate dieten_US
dc.subjectVirta Health studyen_US
dc.subjectIntermittent fastingen_US
dc.subjecttime restricted feedingen_US
dc.subjectmedication deprescribing in type 2 diabetesen_US
dc.titleLifestyle based remission in type 2 diabetes: implications for clinical practiceen_US
dc.typemaster thesisen_US
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