Objective: Type 2 diabetes and obesity have become an epidemic. The aim of this study was to determine the response of type 2 diabetic patients on insulin through the use of dietary education, intense behavioral treatment, and lifestyle changes.
Methods: Sixty-seven type 2 diabetics on insulin were followed in our disease management program, The Diet of Hope, for one year.
Results: Twenty-six patients (40%) discontinued long-acting insulin. Thirty-two patients (49.2%) reduced long-acting insulin. Of twenty-five patients on additional short-acting insulin, twenty-two patients stopped those medications. Despite these reductions, HbA1c (glycated hemoglobin) lowered from 8.3% to 7.2%. The average combined daily insulin dosage for each patient (long-acting and short-acting) was 107.4 units at induction into the program and decreased to 33.2 units after one year. Average weight loss was 25.7 pounds.
The cohort of sixty-seven patients followed for one year reduced their combined daily insulin dosage by a total of 4,971.4 units (1,789,704 units per year). Average cost of one vial of insulin (1000 units) is approximately $250. Cost savings in one year for these sixty-seven patients by reducing or discontinuing insulin was approximately $447,426.
Conclusion: Type 2 diabetic patients on insulin can reduce or discontinue their insulin dosage through carbohydrate restriction and lifestyle change