@article {Potbmjnph-2020-000081, author = {Gerda K Pot and Marieke CE Battjes-Fries and Olga N Patijn and Nynke van der Zijl and Hanno Pijl and Peter Voshol}, title = {Lifestyle medicine for type 2 diabetes: practice-based evidence for long-term efficacy of a multicomponent lifestyle intervention (Reverse Diabetes2 Now)}, elocation-id = {bmjnph-2020-000081}, year = {2020}, doi = {10.1136/bmjnph-2020-000081}, publisher = {BMJ Specialist Journals}, abstract = {Introduction A wealth of evidence supports short-term efficacy of lifestyle interventions in type 2 diabetes (T2D). However, little is known about long-term effects of lifestyle interventions in real-life settings.Methods This observational, single-arm study evaluated long-term impact of {\textquoteleft}Voeding Leeft: Reverse-Diabetes2-Now{\textquoteright}, a 6-month multicomponent lifestyle programme, on glycaemic control and glucose-lowering medication (GLmed) use, other T2D parameters and quality of life in 438 T2D participants at 6, 12, 18 and 24 months using paired sample t-tests, χ2 and generalised linear models.Results At 24 months, 234 participants provided information on GLmed and HbA1c ({\textquoteleft}responders{\textquoteright}). 67\% of the responders used less GLmed, and 28\% ceased all GLmed. Notably, 71\% of insulin users at baseline (n=47 of 66 insulin users) were off insulin at 24 months. Mean HbA1c levels were similar at 24 months compared with baseline (55.6{\textpm}12.8 vs. 56.3{\textpm}10.5 mmol/mol, p=0.43), but more responders had HbA1c levels <=53 mmol/mol at 24 months (53\% vs 45\% at baseline). Furthermore, triglyceride levels (-0.34{\textpm}1.02 mmol/L, p=0.004), body weight (-7.0{\textpm}6.8 kg, p\<0.001), waist circumference (-7.9{\textpm}8.2 cm, p\<0.001), body mass index (-2.4{\textpm}2.3 kg/m2, p\<0.001) and total cholesterol/high-density lipoprotein (HDL) ratio (-0.22{\textpm}1.24, p=0.044) were lower, while HDL (+0.17 {\textpm} 0.53 mmol/L, p\<0.001) and low-density lipoprotein-cholesterol levels (+0.18 {\textpm} 1.06 mmol/L, p=0.040) were slightly higher. No differences were observed in fasting glucose or total cholesterol levels. Quality of life and self-reported health significantly improved.Conclusion This study indicates robust, durable real-life benefits of this lifestyle group programme after up to 24 months of follow-up, particularly in terms of medication use, body weight and quality of life in T2D patients.}, URL = {https://nutrition.bmj.com/content/early/2020/08/17/bmjnph-2020-000081}, eprint = {https://nutrition.bmj.com/content/early/2020/08/17/bmjnph-2020-000081.full.pdf}, journal = {BMJ Nutrition, Prevention \& Health} }