Lifestyle interventions and pharmacology are considered first-line treatment in individuals with type 2 diabetes. While pharmacology improves glycemic control, the therapy is associated with discomfort and adverse events. Little is known about the effect on glycemic control of an intensive lifestyle intervention, with high volumes of exercise, and to what extent exercise-based lifestyle interventions can be used to achieve the glycemic treatment targets during the management of type 2 diabetes. 

The main aim was to assess whether an intensive lifestyle intervention can achieve and maintain the glycemic treatment targets in participants with type 2 diabetes. Secondarily to explore the underlying mechanisms of achieving the glycemic treatment targets and to investigate the rate of remission one year after terminating the intensive lifestyle intervention. 

We conducted a one-year, randomized, assessor-blinded, equivalence trial in overweight participants with type 2 diabetes. Participants were randomized (2:1) to the intensive lifestyle group or standard care group.

A one-year intensive lifestyle intervention led to modest benefits in glycemic control and reduced the need of glucose-lowering medication, possibly due to a larger improvement in the disposition index, an esti ate of beta-cell function. The odds of any remission were fourfold in the intensive lifestyle group compared to standard care.

Bente Klarlund Pedersen, MD, DMSc. Professor, Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Denmark

Mathias Ried-Larsen, PhD. Associate Professor, Centre for Physical Activity Research, Rigshospitalet, Denmark and University of Southern Denmark, Denmark