The American College of Lifestyle Medicine (ACLM), a medical professional society advocating for lifestyle medicine, published a consensus statement that remission can be achieved in type 2 diabetes adults through a plant-predominant diet as the primary intervention. The statement was supported by the American Association of Clinical Endocrinology and the Academy of Nutrition and Dietetics, and was co-sponsored by the Endocrine Society.
 
The publication, written by a panel of 15 experts with representatives from seven medical professional societies, is the first to focus on diet as a primary means of achieving lasting remission of diabetes without medications or procedures, in contrast with the usual role of diet as adjunctive therapy. This approach was supported by the consensus of internists, cardiologists, family physicians, endocrinologists, nutritionists, dieticians, and lifestyle medicine specialists.
 
The experts agreed that diet alone could achieve remission (defined as an HbA1c less than 6.5%) for at least three months without surgery, devices, or active pharmacologic therapy to reduce glucose.
 
Diet as a primary intervention was considered most effective when emphasizing whole, plant-based foods such as whole grains, vegetables, legumes, fruits, nuts, and seeds.
 
“Remission is the optimal outcome for individuals with type 2 diabetes,” said Richard Rosenfeld, MD, MPH, MBA, DipABLM, lead author of the consensus statement and senior liaison for medical society relations at ACLM. “The consensus statements will not only empower clinicians and patients to use a plant-predominant diet as ‘food as medicine’ for achieving remission of type 2 diabetes, but will facilitate shared management decisions based on current best evidence and structured expert consensus.”
 
Type 2 diabetes is estimated to affect 10.5% of U.S. adults and cost $327 billion annually in direct costs and decreased productivity, according to the publication. The condition can result in blindness, kidney disease, cardiovascular diseases, amputation, and other comorbidities that decrease quality of life and contribute to mortality rates.
 
“A healthy diet is a foundational component of current lifestyle guidelines for treatment of type 2 diabetes, but is often overlooked because of the lack of physician training and patient awareness,” AACE president Dr. Felice Caldarella said. “The consensus statements produced by this panel of experts are invaluable in bringing awareness to the value of diet for diabetes remission in addition to management.”
 
In all, the expert panel achieved consensus on 69 statements, relating to diet and remission of type 2 diabetes, dietary specifics and types of diets, adjuvant and alternative interventions, support, monitoring, adherence to therapy, weight loss, payment and policy.
 
The expert panel called for more research into areas that include evaluating the impact of reducing animal foods in promoting remission and assessing whether remission can be obtained with ad libitum food intake consuming whole food, plant-based dietary patterns. Also needed are more randomized controlled trials to assess sustainable plant-based dietary interventions with whole or minimally processed foods, as a primary means of treating type 2 diabetes with the goal of remission.