7 responses to “Lifestyle interventions in type 2 diabetes”

  1. It would have been useful to mention the Lifestyle Rx program which is available to all BC residents, and is covered by MSP. It is an in depth 12 week program supporting all the changes you have mentioned.
    Karen Nishio

  2. I took a course at UBC on low carb eating approaches to reverse diabetes a few years ago. “Eat less, exercise more” does not work. I’m surprised that the article suggests this paradigm with evidence against it. Nutritional ketosis has clear evidence, presented by UBC, for diabetes remission. Advocating unsupported, outdated advice does more harm than good.

  3. Great article thank you.

  4. This is a wonderful article. Thanks for summarizing everything I do in BC, it was right on point. We struggle across Canada to establish evidenced based weight management clinics with a functioning business model concurrently. However, despite this, many clinics use your approaches to Obesity and DM2 management. So it was a critical article for general MDs to read in BC. Thanks again. DEH.

  5. This is a great article! I am so happy to share with my clients that remission may be possible. This may also help mitigate some of the diabetes distress so many people with diabetes face. Many of my clients are used to providers chasing A1C numbers and this gives back some of the control to the patient. Thank you.

  6. Response to Joanne Parker:
    Thank you for sharing your thoughts. In this article, I focused on the evidence that diabetes remission is possible through weight loss rather than specific ways to lose weight. Though I did cite evidence of calorie restriction and increased physical activity being an effective means of weight loss to achieve remission of diabetes, it is not the only way. The evidence tells us that sustainable weight loss is more nuanced than simply eat less and exercise more. Whether and how people attempt to lose weight is very much an individualized discussion dependent on the available evidence, the person’s resources and their desired outcome, and collaboration with the health care team.

  7. Great article Dr. McCorquodale!

    I would resonate with your response to Dr. Parker, and add to it – the evidence is also extremely clear that without calories burned in excess of total intake there is no change in weight and likely other metabolic parameters. I have a deep love and respect for ketogenic approaches as a therapeutic modality, but it is quite possible to gain weight on a LCHF diet if out of caloric balance. “Eat less, move more” is can certainly be poor advice as a basic counsel, but when paired with an appropriate behaviour change strategy and a nuanced understanding of the physiology underpinning a patient’s current metabolic state, I would argue it still serves as a foundation of what we aim to achieve with patients by one strategy or another.

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