The Power of Lifestyle Intervention for Glycaemic Control in Newly Diagnosed Type 2 Diabetes Mellitus – Case Report

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Introduction: The standard therapeutic approach for patients manifesting with newly diagnosed type 2 diabetes and HbA1c levels above 10% involves prompt pharmacotherapy, frequently incorporating insulin underestimating the potential of significant impact of lifestyle changes. The BELIFE study investigates the effect of a lifestyle intervention in patients with uncontrolled newly diagnosed type 2 diabetes (HbA1c>7.5%) on glucose control. We report an illustrating patient vignette of this trial. Objectives: Presentation of a case report to demonstrate the efficacy and safety of a lifestyle intervention only on glycaemic control in a person with newly diagnosed type 2 diabetes and significantly elevated HbA1c level. Methods: A 48-year-old male patient was diagnosed with type 2 diabetes mellitus (HbA1c 10.3%). The patient participated in the BELIFE study (NCT03827382), a randomized, controlled trial comparing an intensive lifestyle regimen to standard of care in patients with newly diagnosed type 2 diabetes. The intervention group encompasses an intensified lifestyle approach with increased physical activity three to five aerobic training sessions per week (15-40 minutes each), two strength training sessions, and a psychological coaching once a week for three months without any antidiabetic medication. Daily activity was monitored using blinded activity tracker. Blood glucose levels and body composition are checked at randomization and after three months using bioelectrical impedance analysis (BIA). Results: HbA1c level decreased from 10.3% to 6.0% within three months with lifestyle modification only. Body weight remained stable 98.4 kg (BMI 31.8 kg/m 2 ). Simultaneously, a decline in fat mass of 3.2 kg (from 31.6 kg to 28.4 kg) and a gain in skeletal muscle mass of 1.5 kg (from 32.7 kg to 34.2 kg) were observed. Furthermore, a reduction in visceral fat of 1.2 litres (from 4.9 litres to 3.7 litres) and a decrease in waist circumference of 5 cm (110 cm vs 105 cm) was shown. Conclusion: This case demonstrates that comprehensive lifestyle interventions in type 2 diabetes are extremely effective even despite significantly increased HbA1c levels at diagnosis of diabetes. This case report underscores the potential of targeted lifestyle interventions to achieve substantial glycaemic control. Publication History Article published online: 25 May 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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