Background

The incidence of type-2 diabetes (T2D) has amplified worldwide, but significant improvement in overall health outcomes is not observed. A low carbohydrate diet (LCD) is suggested as a nutritional strategy for diabetics to control blood glucose levels, but the outcomes are usually short-term and often unsustainable. Various studies have demonstrated sustained remission of T2D through lifestyle intervention including a whole food plant-based diet (WFPBD) with moderate glycemic load (MGL) combined with insulin sensitivity optimization (ISO) techniques like Intermittent Fasting (IF), Time Restricted Eating (TRE), and Fractional Exercise (FE).

Methods

We present a case series of four diabetic patients who participated in our 180-day diabetes reversal program (DRP) in 2023. The intervention was a combination of MGL-oriented WFPBD along with ISO techniques like IF, TRE, and FE delivered over 180 days. The primary measures were changes in glycated hemoglobin (HbA1c), fasting blood glucose (FBG), body weight (BW), and body mass index (BMI).

Results

The HbA1c values of the participants reduced from 13.3%, 12.5%, 9.5%, and 9.2% to less than 6.5% without any diabetes medications, and thus, they achieved diabetes remission as per definition. Significant improvements were also observed in FBG, BW, and BMI. All the participants sustained the remission at 6 months interval of follow-up.c

Conclusions

The findings of the case series suggest that a structured lifestyle modification program combining MGL-oriented WFPBD with ISO techniques like IF, TRE, and FE can significantly improve metabolic health parameters leading to sustainable remission of T2D.