by Elana Gotkine

For adults with advanced, insulin-treated type 2 diabetes (T2D), willingness to participate in an intensive lifestyle intervention (ILI) is very low, according to a research letter published online June 5 in Diabetes, Obesity and Metabolism.

Cathy J. Sun, M.D., from The Ottawa Hospital in Ontario, Canada, and colleagues designed an ILI pilot project for adults living with T2D, who were insulin-treated for at least five years, and with a body mass index of 27 to 45 kg/m².

The intervention was a 24-week ILI composed of three phases: four weeks of daily negative energy balance of 800 calories; four weeks of daily negative energy balance of 500 calories; and daily neutral energy balance for 16 weeks. Patients would have medication management monitoring and on-call privileges to the study's physician throughout the study.

The researchers found that 83 (15.0 percent) of the 555 patients screened met the inclusion criteria and were contacted by research assistants. Only two patients (0.4 percent) were potentially interested; one had extensive travel plans and the second subsequently did not want to participate.

Eight-one patients refused to participate because the initial diet was too restrictive in daily calories, because the intervention was too demanding and would interfere with social life, and because of the requirement for multiple medication adjustments. The perception that the intervention was too intense was the main reason for refusal to participate.

"Optimal ways to approach and support patients with insulin-treated T2D for ILI remain to be established," the authors write.

More information: Cathy J. Sun et al, The daunting task of recruiting insulin‐treated patients living with type 2 diabetes mellitus for intensive lifestyle interventions, Diabetes, Obesity and Metabolism (2024). DOI: 10.1111/dom.15688

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