Type 2 diabetes: a growing problem
In the Netherlands an estimated 800,000 to 900,000 people suffer from type 2 diabetes. In addition, about 250,000 people have type 2 diabetes without knowing it, while a further 750,000 people run an increased risk of developing this disease. The total number of patients in the Netherlands is expected to grow to 1.2 million by 2030. Patients with type 2 diabetes suffer from fatigue, increased thirst and frequent infections, in addition to irregular blood sugar levels and increased risk of cardiovascular disease. Current clinical practice is that patients receive medication and dietary advice through their GPs and dieticians. However, research shows that the standard dietary recommendations for type 2 diabetes patients only have short-term effects (Langeveld, Nederlands Tijdschrift voor Geneeskunde, 2013).
The Louis Bolk Institute has published a study evaluating a six-month pilot programme executed by Voeding Leeft providing intensive counselling on nutrition and lifestyle, a digital coaching and education platform, physician-guided medication management and cooking classes aim towards diabetes type 2 patients.
Developed by the Dutch Foundation ‘Voeding Leeft’ (Nutrition Alive), the programme ‘Reverse Diabetes2 Now’ aims to explain the cause and underlying physiology of type 2 diabetes and pays specific attention to developing knowledge on type 2 diabetes and nutrition, managing stress, mental obstacles and exercise routines. Participants, as well as their partners, were encouraged to support each other, and share their experiences, as a way to increase effectiveness. Participants also received instant biometric feedback, by routinely measuring their blood glucose levels after meals, and by regularly measuring their waist circumference. Reverse Diabetes2 Now adopts a different approach focusing on lifelong lifestyle changes, including fresh, unprocessed foods and no restriction on calories. Guidance is provided for six months by a support team, including a dietician, a personal coach and a nurse who works in collaboration with the patient’s GP.
Out of the 72 participants who completed the study, results showed that:
- At the beginning of the study, 65 of the 72 participants (90%) used glucose lowering medication. After 6 months, 35 of the 72 participants (49%) used less medication of whom 9 participants (13%) ceased all glucose lowering medication and 11 participants (15%) were able to come off insulin.1
- There was a significant drop in HbA1C levels, with 64% of participants above 53mmol/mol at the start, dropping to 40% of participants above 53mmol/mol after six months.1
- After 6 months, participants felt less fatigued, had higher levels of concentration, were more motivated to be physically active, and also experienced fewer sleeping problems.1
- Body weight (-4,9 kg), waist circumference (-9,4 cm) and BMI (1,7 kg/m2) were lower after six months.1
- A larger scale follow-up study to this pilot study is now well underway.
1) Publication in BMJ Nutrition, Prevention and Health: Nutrition and lifestyle intervention in type 2 diabetes: pilot study in the Netherlands showing improved glucose control and reduction in glucose lowering medication by Gerda Pot et al 2019
Lead author Dr Gerda Pot from the Louis Bolk Institute and King’s College London said: “Treating the underlying causes of a lifestyle disease like type 2 diabetes in a sustainable lifestyle change sounds logical but not many studies use this approach. This pilot study of a lifestyle intervention program is a good step in the direction of providing evidence how type 2 diabetes can be cured with lifestyle interventions and healthy nutrition.”