Remission of Type 2 Diabetes through Moderate Glycemic Load (MGL) Diet and Insulin Sensitivity Optimization (ISO) Techniques: A Case Series

Background: The incidence of type-2 diabetes (T2D) has amplified worldwide, but significant improvement in overall health outcomes is not observed. A low carbohydrate diet is suggested as a nutritional strategy for diabetics to control blood glucose levels, but the outcomes are usually short-term and often unsustainable. Various studies have demonstrated sustained remission of T2D through lifestyle intervention including a whole food plant-based diet (WFPBD) with moderate glycemic load (MGL) combined with insulin sensitivity optimization (ISO) techniques such as intermittent fasting and fractional exercise. Methods: This article presents a case series of four diabetic patients who participated in an online 180-day diabetes reversal program in 2023. The intervention was a combination of MGL-oriented WFPBD along with ISO techniques including intermittent fasting and fractional exercise. The primary measures were changes in glycated hemoglobin (HbA1c), fasting blood glucose (FBG), body weight (BW), and body mass index (BMI). Results: The HbA1c values of the participants reduced from 13.3%, 12.5%, 9.5%, and 9.2% to less than 6.5% without any diabetes medications, and thus, they achieved diabetes remission as per the definition set by the American Diabetes Association. Significant improvements were also observed in FBG, BW, and BMI. All the participants remained in remission beyond the 12-month interval period with HbA1c below 6%. Conclusions: The findings of the case series suggest that a structured lifestyle modification program combining MGL-oriented WFPBD with ISO techniques such as intermittent fasting and fractional exercise can significantly improve metabolic health parameters leading to sustainable remission of T2D.