Optimizing cardiovascular health with a type 2 diabetes remission program: Ultraprocessed food‐intake reduction, Mediterranean diet, chrononutrition and physical training—The DIABEPIC‐2 pilot study

Aims The possibility of type 2 diabetes (T2D) remission following very‐low caloric restriction has been demonstrated. However, the feasibility of T2D remission following other health behavioural interventions remains to be explored. Materials and Methods The DIABEPIC‐2 pilot study assessed the feasibility of a 6‐month programme based on ultra‐processed food intake reduction, a Mediterranean diet, and physical training. Also, a randomised 2:1 proportion of participants added intermittent fasting (IF) in the last 3 months. The study explored the T2D remission rate and its impact on cardiometabolic and anthropometric parameters, cardiorespiratory fitness, and quality of food matrix. Results Feasibility was demonstrated with a recruitment rate of 6.4 participants/month, 34 participants (81%) who completed the programme, with an 87% attendance rate (63.6 ± 9.2 years old, initial mean HbA1c of 6.7 ± 0.7%, mean T2D duration of 7.4 ± 6.7 years). At 6 months, participants had a mean weight loss of −6.8 kg (−9.3 to −4.4, p < 0.001), and 13 participants out of 34 (38%) achieved T2D remission. Overall, participants significantly improved cardiometabolic health and anthropometric parameters, cardiorespiratory fitness, and food matrix quality. Participants randomised to the IF add‐on intervention group did not show significant additional improvement. Conclusion The DIABEPIC‐2 program enabled a significant proportion of participants to achieve T2D remission and to improve their cardiovascular health; therefore, it would be relevant to confirm these results. The recruitment and visit completion rates observed in this pilot study further demonstrate its feasibility, supporting the rationale for conducting a larger randomized clinical trial.