Affiliation:
1. Department of Community Medicine, SMBT Institute of Medical Sciences and Research Centre, Igatpuri, Maharashtra, India
2. Consulting Physician, Nashik, Maharashtra, India
3. Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
4. SMBT Institute of Medical Sciences and Research Centre, Igatpuri, Maharashtra, India
Abstract
ABSTRACT
Background:
Type 2 Diabetes (T2D) is a global challenge with rising prevalence, inadequate compliance, and poor outcomes.
Aims:
Assess the effect of a 2-only-daily-meals with exercise lifestyle (2-OMEX) on (a) HbA1c, (b) anti-diabetic medication count (ADMC), (c) Kcal intakes, body weight, fasting insulin, and subjective well-being.
Materials and Methods:
This is a single-arm follow-up study conducted in a free 2-OMEX clinic in 2019–2020. Information for two meals and exercise compliance was obtained during the clinic visit. HbA1c was tested by HPLC and fasting insulin by the CLIA/CMIA method in private laboratories.
Results:
Eligible subjects (f = 49, m = 116) completing two or more visits and 60 days of follow-up had a mean age of 55.92 (10.43) years, a T2D duration of 8.20 (6.28) years, and a median observation period of 140 days. Statistically significant changes included HbA1c decline from 7.69 (1.70) to 7.00 (1.20) gm% (equivalent by the LogNormal method to 1.088 gm%), average weight loss at 5%(m), and 2%(f). ADMC declined from 2.32 to 2.14, the difference being significant with the WSR test (z = 2.0087, P = 0.0223). Subjects attaining anti-diabetic medication-free and normoglycemic status (HbA1c < 6.5 gm%) were 20 (12%). The number attaining HbA1c ≤ 7 gm%) significantly rose from 73 (44%) to 101 (61%) with an ADMC of 1.9 (chi-square = 9.531, df1, P = 0.0020203). Participants reported ‘feeling energetic’ (79%), feeling lighter (50%), and better sleep (35%). Average energy intakes dropped by 120 Kcal to 1580/day. Fasting insulin remained unchanged, from 12.61 (11.06) to 12.34 (11.78) mlU/L. The dropout rate was 35%.
Conclusions:
The 2-OMEX lifestyle showed a sizeable, favorable, and significant change in HbA1c, body weight, ADMC use in five months, and subjective benefits. Studies are necessary for remission impact and pathways.