Abstract 4142028: An Intensive Lifestyle Intervention Improves Cardiovascular Health Outcomes in Patients with Type-2 Diabetes

Background: Type 2 diabetes (T2D) is associated with an elevated risk of cardiovascular (CV) complications, including hypertension, dyslipidemia, obesity, and inflammation. Addressing CV risk factors is crucial for reducing morbidity and mortality in affected individuals. Integrated lifestyle interventions have emerged as promising strategies for managing T2D and its associated CV risks, emphasizing the importance of dietary modifications, physical activity, and stress management in improving health outcomes Research Aim This study evaluated the impact of an intensive lifestyle intervention (ILI) on both traditional and non-traditional cardiovascular risk factors in patients with type 2 diabetes (T2D) Methods: This retrospective study of 6028 patients diagnosed with T2D (≥18 years), who enrollled in a one-year online ILI program at Freedom from Diabetes Clinic, Pune, India between January 2021 and December 2022. The intervention included a personalized plant-based diet, exercise regimen, stress management, and medical support. Baseline and endline data on CV risk factors, socio-demographics, anthropometry, and medical history were extracted. The primary outcome was an improvement in the CV profile. Results: The mean age of the study population was 51.7±10.4 years (64% male) with a mean diabetes duration of 10.9±7.6 years. At baseline, the majority (67.7%) were on glucose-lowering medication; 39.9% and 51.9% were on anti-hypertensives and statins, respectively. Despite being on medication, 70.2% had poor glycemic control (HbA1c>7%); while dyslipidemia (triglycerides ≥150 mg/dl), obesity (≥25 kg/m2), and hypertension (≥140/90 mmHg) affected 38.8%, 56.3%, and 18.7% of the patients, respectively. Following intervention, there was significant improvement in HbA1c (-17.1%) and weight (-5.3%) (p<0.05). Significant improvements in traditional CV risk factors such as obesity (decreased to 43.2%) and dyslipidemia (decreased to 30.1%) were observed (p<0.05). Moreover, there was significant improvement in non-traditional risk factors (p<0.05), including urine microalbumin (≥25 µg/ml; decreased from 17.8% to 12.9%), CRP (1–10 mg/dl; decreased from 57.7.3% to 56.5%), and postprandial hyperglycemia (>140 mg/dl; decreased from 65.7% to 48.7%). Conclusion: The ILI program showed significant improvements in CV risk factors and glycemic parameters among patients with T2D highlighting the impact of a comprehensive approach to managing CV risks associated with T2D.