564-P: Long-Term Follow-up of Glycemic Excursion Minimization (GEM) Compared with Weight Loss in Management of Type 2 Diabetes (T2D)

Abstract

In a recent randomized clinical trial, we compared 6 hours of conventional weight loss (WL) training to an equivalent amount of Glycemic Excursion Minimization (GEM) that is a paradigm-shift in lifestyle management for adults with T2D. GEM focuses on diminishing post-nutrient BG excursions by: 1) minimizing BG upsurge by reducing net carbohydrate ingestion, and 2) hastening BG recovery by increasing routine and post-meal physical activity.1 We now present the 13-month follow-up data, with no further training or contact, to evaluate the relative durability of these interventions. All of the WL and 97% of GEM participants who completed 3-month post-assessment also completed 13-month follow-up. At 13 months, WL participants sustained the improvement in BMI they showed at 3 months, while GEM participants continued to significantly benefit from lower HbA1c (p<.001), diabetes medication usage, cardiovascular risk, BMI, HDL, and improved psychological function regarding empowerment and diabetes distress (p’s <.01). Fifty-two percent of GEM participants were classified as Responders (mean HbA1c reduction of -1.5%). Being a GEM Responder at 13 months was unrelated to demographic or disease severity variables. Regression analyses indicated being a GEM long-term Responder was preceded by short-term post-treatment reduction of HbA1c, BMI and diabetes medication, correctly classifying 76% of eventual Responders and Non-responders. WL Responders could not be identified. Our data suggest GEM is a sustainable treatment option in the management of T2D. 1BMJ Open Diabetes Research & Care, 8:e001795. doi: 10.1136/bmjdrc-2020-001795. Disclosure D. Cox: Research Support; Self; Abbott Diabetes, Dexcom, Inc. M. A. Moncrief: Research Support; Self; Abbott Diabetes, Dexcom, Inc. A. L. Mccall: None. Funding National Institutes of Health (DK108957)