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Nutrition
Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication
  1. Gerda K Pot1,2,
  2. Marieke CE Battjes-Fries1,
  3. Olga N Patijn1,
  4. Hanno Pijl3,
  5. Renger F Witkamp4,
  6. Marianne de Visser5,
  7. Nynke van der Zijl6,
  8. Maaike de Vries7 and
  9. Peter J Voshol1
  1. 1Department of Nutrition and Health, Louis Bolk Instituut, Bunnik, The Netherlands
  2. 2King's College London, Division of Diabetes and Nutritional Sciences, London, UK
  3. 3Division of Internal Medicine, Leids Universitair Medisch Centrum, Leiden, The Netherlands
  4. 4Division of Human Nutrition and Health, Wageningen Universiteit, Wageningen, The Netherlands
  5. 5Department of Neurology, AMC, Amsterdam, The Netherlands
  6. 6General Practitioner, Medical Centre te Cleeff, Haarlem, The Netherlands
  7. 7Springh, Den Haag, The Netherlands
  1. Correspondence to Dr Gerda K Pot, Louis Bolk Instituut, Bunnik 3981 AJ, The Netherlands; g.pot{at}louisbolk.nl

Abstract

Introduction Prevalence of type 2 diabetes (T2D) is increasing rapidly and lifestyle interventions to reverse diabetes are seen as a possible solution to stop this trend. New practice-based evidence is needed to gain more insight in the actual, and above all scientific, basis for these claims.

Methods This observational study with a pretest post-test design aimed to pilot a 6-month multicomponent outpatient group-based nutrition and lifestyle intervention programme on glycaemic control and use of glucose lowering medication in motivated T2D patients with a body mass index (BMI) >25 kg/m2 in the Netherlands (February 2015–March 2016).

Results 74 T2D patients (56% female) aged 57.4±8.0 years with mean BMI 31.2±4.2 kg/m2 and mean waist circumference 105.4±10.2 cm were included in the study. Compared with baseline, mean HbA1c levels at 6 months were 5 mmol/mol lower (SD=10, p<0.001) and the number of participants with HbA1c levels ≤53 mmol/mol after intervention had increased (from 36% (n=26/72) to 60% (n=43/72)). At baseline, 90% of participants were taking at least one type of glucose lowering medication. At 6 months, 49% (n=35/72) of the participants had reduced their medication or eliminated it completely (13%). Secondary outcomes were significantly lower fasting glucose levels (− 1.2±2.6 mmol/L), body weight (−4.9±5.1 kg), BMI (−1.70±1.69 kg/m2) and waist circumference (−9.4±5.0 cm). Plasma lipids remained unchanged except for a decrease in triglyceride levels. Furthermore, self-reported quality of life was significantly higher while experienced fatigue and sleep problems were significantly lower.

Conclusion This pilot study showed that a 6-month multicomponent group-based program in a routine care setting could improve glycaemic control and reduce the use of glucose lowering medication in motivated T2D diabetics. A fully scaled study is needed to confirm these results.

  • type 2 diabetes
  • reversing
  • lifestyle intervention
  • nutrition
  • proof of practice
  • multidisciplinary

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjnph-2018-000012

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    Footnotes

    • Contributors GKP and MCEB-F analysed the data, and drafted and revised the manuscript; ONP and NvdZ drafted and revised the manuscript. HP and RFW are members of the scientific advisory board of Voeding Leeft, and provided scientific input to design of the study and manuscript. MdV provided scientific input to the design of the study and manuscript. PJV designed the lifestyle intervention, drafted and revised the manuscript and is responsible for the overall content of the manuscript (guarantor). PJV is also co-founder of the Voeding Leeft Foundation.

    • Funding This work was supported by VGZ Health Insurance via the foundation Voeding Leeft and by Ekhaga (application number 2017-55).

    • Competing interests GKP, MCEB-F, ONP and PJV report grants from Ekhaga Foundation, grants from Voeding Leeft, during the conduct of the study; MdV reports personal fees from null, outside the submitted work; RFW reports that he is member (chair) of the scientific advisory board (Deelnemersraad) of the Voeding Leeft Foundation, for which he receives no financial or other compensation; HP and NvdZ have nothing to disclose; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, no other relationships or activities that could appear to have influenced the submitted work.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by Healthcare partners Friesland.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.