A recent study published in Diabetes Research and Clinical Practice has revealed the effectiveness of a telemedicine-based intervention for type 2 diabetes (T2D), utilizing a very low-carbohydrate diet to achieve nutritional ketosis. The study highlights that over a five-year period, the approach not only helped participants lose weight but also improved several health markers and led to diabetes remission for some.
Significant Health Improvements and Diabetes Remission
The study followed individuals with T2D who had a body mass index (BMI) greater than 25, analyzing the long-term effects of telemedicine care. Participants were guided through an app that offered nutrition counseling and diabetes medication management, focusing on restricting carbohydrate intake to less than 30 grams per day. The intervention resulted in notable health improvements, including a 17.4% increase in HDL cholesterol, an 18.4% reduction in triglycerides, and a significant drop in inflammation markers such as a 43.6% decrease in high-sensitivity C-reactive protein (hs-CRP).
One of the study’s key findings was that 20% of participants achieved diabetes remission after five years, with 32.5% lowering their glycated hemoglobin (HbA1c) levels to below 6.5% without using medication or relying only on metformin. Among those who achieved remission by the second year, 57.6% were still in remission at the five-year mark, demonstrating the durability of the intervention’s effects.
Weight Loss and Reduced Medication Use
The participants in the study also experienced significant weight loss, with 61.3% achieving a 5% reduction and nearly 40% maintaining a 10% weight loss over five years. The continuous support through telemedicine allowed participants to monitor their weight, blood sugar, and beta-hydroxybutyrate (BHB) levels, while interacting with health coaches and a peer support community. These sustained lifestyle changes contributed to improved blood sugar control and decreased reliance on diabetes medications.
The need for medications other than metformin dropped considerably, with participants’ use of diabetes medication decreasing from 85.2% to 71.3%. The study also reported that the average daily insulin dose fell significantly from the baseline levels, further reducing the medication burden for many individuals.
Comparison and Future Implications
Compared to other lifestyle therapy trials, the diabetes remission rates achieved in this study exceeded expectations. For instance, the Look AHEAD trial achieved a remission rate of 7.3% over four years, while the DiRECT trial reported 13% remission at five years. In contrast, 20% of the participants in this study reached remission at the five-year mark. The continuous remote care, peer support, and strict adherence to a low-carbohydrate diet were credited with the study’s success.
Although the results were promising, researchers noted that the lack of a comparison group and limited racial diversity in participants were limitations of the study. Despite this, the findings suggest that carbohydrate-restricted diets paired with telemedicine could be an effective long-term strategy for managing type 2 diabetes, potentially reducing the need for medication and improving overall health outcomes.
This intervention highlights the growing role of telemedicine in providing accessible, continuous care for chronic diseases like diabetes, offering new hope for lasting diabetes remission and better quality of life for individuals managing T2D.
