The Lifestyle Prescription: Unraveling the Impact on Type 2 Diabetes Management

WORLD DIABETES DAY 2023

Can Type 2 Diabetes be reversed?

Today is World Diabetes Day, and the theme of 2023 is “Empowering Global Health”.

With the rise in the prevalence of diabetes worldwide, there is an urgent call for global action to stem this growing problem.

Singapore has one of the fastest-growing rates of diabetes, with over 400,000 people living with diabetes today and ranking first in the world for incidence of diabetes-induced kidney failure. However, it is not all doom and gloom!

There are various types of recognised diabetes. In this article, we will focus on Type 2 diabetes mellitus, a chronic metabolic disorder characterised by high blood sugar due to the body’s inability to utilise the hormone insulin effectively.

Type 2 diabetes is a complex and multifactorial condition that can be progressive and result in several complications. A strong family history and multiple modifiable lifestyle factors such as poor diet, physical inactivity and being overweight can contribute. Conditions such as a history of gestational diabetes and polycystic ovary syndrome can also increase your risk of developing type 2 diabetes.

Type 2 Diabetes and GLP – 1 Medications

New medications are now available, including the GLP-1 (glucagon-like peptide-1) agonists, which have been making headlines for their weight loss properties.

These mimic the effects of GLP-1, a naturally occurring hormone that stimulates insulin release, lowering blood sugar levels. In addition, they have other effects that help regulate sugar levels. This includes inhibiting another hormone called glucagon, which stimulates sugar release from the liver, thus further lowering blood sugar levels. In addition, they slow down gastric emptying, helping control the blood sugar level after a meal and regulate appetite by making patients feel more satiated after a meal. GLP-1 has also been shown to improve beta cell function in the pancreas (the cells responsible for insulin production), and they have been found to have some cardiovascular benefits.

These medications can be used as part of a comprehensive treatment plan for type 2 diabetes, which should always include lifestyle modification. Diabetes management guidelines worldwide highlight the importance of lifestyle intervention and, depending on the severity and duration of the diabetes, may be used alone or together with medication.

Lifestyle Medicine and Diabetes

Several studies have demonstrated that lifestyle interventions, including changes in diet and exercise, can lead to the reversal or remission of type 2 diabetes in some individuals.

The DiRECT Study (Diabetes Remission Clinical Trial) implemented a low-calorie diet, followed by a gradual reintroduction of normal foods and ongoing support for weight maintenance. The results showed that nearly half of the participants achieved diabetes remission in one year. 

The Look AHEAD Study (Action for Health in Diabetes) found that participants who engaged in intensive lifestyle interventions, including dietary changes and increased physical activity, experienced significant improvements in glucose control, weight loss, and cardiovascular risk factors.

These studies, along with others of a similar nature, offer a promising outlook for patients, suggesting that beyond medication, lifestyle interventions can play a pivotal role in the reversal of diabetes and stemming advancement and complications of diabetes. When coupled with close medical supervision, health coaching becomes a valuable tool, providing guidance and motivation for patients to incorporate evidence-based lifestyle changes.

During a Lifestyle Medicine Consultation, the six pillars of health are addressed, particularly nutrition and physical activity, to help patients implement sustainable changes into their daily routines. A Continuous Glucose Monitor (CGM) may be used to monitor glucose levels in real-time, make more informed decisions about lifestyle choices, and help tailor a personalised lifestyle plan.

What can you do?

Before diabetes develops, insulin resistance and pre-diabetes set in. This is where early lifestyle interventions are most successful at putting the breaks on the development of diabetes.

If you have a strong family history of diabetes, a history of gestational diabetes, polycystic ovary syndrome, or metabolic syndrome or are overweight, then consider screening for pre-diabetes/ diabetes and start making preventative lifestyle changes. If you need help understanding and implementing these changes, book a Lifestyle Medicine Consultation for further assessment and health coaching.

For those with diabetes, either newly diagnosed or established, who are keen on reducing their medication, managing their diabetes without medication (if it is safe to do so) or reversing the conditions, then book a Lifestyle Medicine Consultation to learn more about how we can support you in achieving these goals.