1523-P: Remission and Metabolic Outcomes in Drug-Naïve Indian Type 2 Diabetes Patients following One-Year Intensive Lifestyle Intervention

Introduction and Objective: Type 2 diabetes (T2D) is a major health crisis in India, with 11-20% of patients being drug-naïve despite longer diabetes duration. Drug-naïve status predicts better remission through intensive lifestyle interventions (ILI; remission defined as HbA1c 6.5% for ≥3 months without medications), yet data are limited. This study evaluates remission rates and metabolic improvements in drug-naïve T2D patients following a one-year ILI program. Methods: We analyzed data from 459 drug-naïve adult T2D patients enrolled in a one-year online ILI at a diabetes management clinic in India. The program comprised plant-based diet (with juice feasting), structured exercise, stress management, and medical support. Primary outcomes were predictors of remission and biochemical improvements. Results: Baseline median values were: age 50 years (IQR: 44-56), diabetes duration 4.1 years (IQR: 2.6-6.0), HbA1c 6.8% (6.5-7.6), and BMI 27.1 kg/m² (24.5-30.8); 56.6% were male. Post-intervention, 76.9% achieved remission. Significant improvements occurred in HbA1c, weight, BMI, fasting blood glucose (FBG), fasting insulin, HOMA2-IR, HOMA2-B, lipid profile, and blood pressure (P0.05). Remission patients showed greater reductions (%) vs. non-remission: weight (-7.5 vs. -2.7), BMI (-7.6 vs. -2.8), HbA1c (-13.4 vs. -5.7), FBG (-11.7 vs. -6.5), fasting insulin (-19.4 vs. -9.8), and HOMA2-IR (-22.9 vs. -9.4), with improved HOMA2-B (11.4 vs. -0.70) and HDL-C (females: 9.0 vs. -0.15; males: 9.3 vs. 2.0) (P0.05). Three predictors emerged: baseline HbA1c 7% (OR 2.6, 95% CI: 1.5-4.6), weight loss 6% (OR 4.2, 95% CI: 2.5-7.0), and juice feasting adherence (OR 1.7, 95% CI: 1.1-2.8) (P0.05). Conclusion: ILI shows potential to induce remission in drug-naïve T2D patients, with three in four achieving remission. These findings are particularly relevant in India, where many patients prefer non-pharmacological approaches before initiating medications, highlighting the importance and efficacy of early lifestyle intervention. Disclosure P. Tripathi: None. D. Tiwari: None. N.S. Kadam: None. A. Vyawahare: None. T.R. Kathrikolly: None. B. Sharma: None. M. Ganla: None. B. Saboo: None.