A whole-food, plant-based intensive lifestyle intervention improves glycaemic control and reduces medications in individuals with type 2 diabetes: a randomised controlled trial
An erratum to this article was published (Diabetologia, Feb 2025 ↗)
Authors' conclusion
A whole-food, plant-based lifestyle intervention was more effective for improving glycaemic control than SMC. It also reduced the need for diabetes and cardiovascular medications and induced diabetes remission in some participants. Therefore, it is an effective, evidence-based lifestyle option for individuals with type 2 diabetes.
Study context
- Population
- Adults aged 18–75 years with T2D in the Marshall Islandsrandomised 1:1
- Participants
- 169 adults
- Comparison
- Whole-food, plant-based intervention with moderate exercise (PB+Ex) vs standard medical care (SMC)
- PB+Exn = 79
- SMCn = 90reference
- Primary endpoint
- Glycaemic control (HbA1c, glucose, insulin and HOMA-IR) and glucose-lowering medication use
- Follow-up
- 24 weeks
Methodological detailsparallel-arm, 1:1 randomisation, only lab analysts blinded
- Parallel-arm
- 1:1 randomisation
- Only lab analysts blinded
Primary result
HbA1c change · week 24
Additional decrease
8 mmol/mol (0.7%)
P = 0.01
Change by group
PB+Ex
−16
mmol/mol
SMC
−8
mmol/mol
As reported in the abstract
- Medicated participants who reduced glucose-lowering medications, PB+Ex vs SMC
- 63% vs 24%; p=0.006
Secondary outcomes
| Outcome | PB+Ex | SMC | Estimate | P value |
|---|---|---|---|---|
| HbA1c change · week 12Greater decrease with PB+Ex | −22 mmol/mol | −7 mmol/mol | additional decrease 14 mmol/mol (1.3%) | P < 0.0001 |
| % | −2.0% | −0.7% | ||
| Weight, C-reactive protein and CV medication use | weight change −2.7 kg | P < 0.0001 | ||
| Weight, C-reactive protein and CV medication use | C-reactive protein change −11 nmol/l | P = 0.005 |
- Remission in PB+Ex participants with baseline HbA1c <75 mmol/mol (<9%)
- 23%
Weight, C-reactive protein and CV medication use
- PB+Ex reduced CV medication use vs SMC
Glucose, insulin, HOMA-IR, cholesterol, TG and heart rate · intermediate timepoints
- Improved with PB+Ex at intermediate timepoints, but not at week 24
Original publication
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