Intensive Diet and Physical Activity on Diabetes

Prior treatment

• Currently taking medications known to affect weight (e.g. anti thyroid drugs, glucocorticoids);

Other illness

• History consistent with type 1 diabetes;
• Severe cardiovascular disease:
  • current angina
  • myocardial infarction within last six months
  • heart failure
  • symptomatic periphery vascular disease
• Uncontrolled hypertension: systolic blood pressure \> 180 mmHg or diastolic blood pressure \> 100 mmHg;
• Myocardial ischemia indicated by resting ECG;
• Foot ulcers, peripheral neuropathy or skeletal disorders;
• Malignant tumor in active-stage, or in remission stage but less than 5 years from the most recent treatment
• Past or present confirmed psychiatric illness or drug dependence;
• History of food allergies;
• Surgical history of digestive system;
• Known to have metabolism-affecting diseases;
• Known to have infectious diseases within last month;
• Other acute diseases supported by clinical evidence which may contradict to the interventions;
• Failure to obtain informed consent from participant;
• Any other medical condition judged by the clinic team not eligible for the trial.

Lab values

• ALT or AST levels more than twice the upper limit of the normal range or active liver diseases;
• eGFR \<60 ml/min/1.73 m2, or serum creatinine \>1.5 mg/dl for men or 1.3mg/dl for women; or Proteinuria
• Hemoglobin concentration \<130 g/l for men or \<120 g/l for women;
• Known to have weight-affecting diseases (e.g. malabsorption, functional bowel disease, uncontrolled low sodium/hyperthyroidism, eating disorders);
• Possible consumption of food or drugs affecting glucose homeostasis or gut microbiota within the last three months;

Other

• Insulin treatment;
• Taking high intensity exercise more than 75 minutes or moderate intensity exercise more than 150 minutes per week during the screening phase
• Average weekly alcohol intake \>140 grams for men and \>70 grams for women;
• Pregnancy, currently trying to become pregnant, or of child-bearing potential and not using birth control;
• Currently participating in another intervention study;
• Any factors judged by the clinic team to be likely to limit adherence to interventions;

• Men and women aged 40-70 years;
• Newly diagnosed type 2 diabetes
  • Duration of type 2 diabetes ≤ 2 years;
  • Antidiabetic treatment maintained for at least 6 weeks before recruitment;
• 7.0%≤ HbA1c \< 9.0%;
• 25 Kg/m2 ≤ Body mass index (BMI) \<40 Kg/m2;