Effect of diet and physical activity on achieving remission of type 2 diabetes mellitus.

A comprehensive, holistic intervention was carried out over six months, incorporating tailored dietary plans, physical activity, and medication optimisation guidance. The details are shared below 1. Dietary intervention: One on one session was done for a period of six months. A virtual assessment using voice, video, and text communication was employed, These sessions aimed to provide dietary counselling based on the client's health needs. This was done by a nutritionist who was part of this project. The session was for 30 minutes on weekly basis and a follow up was made using whats app. Additionally a whats app group was also made for sending reminders and reinforcing dietary intervention. 2. Physical exercise: A life style expert was also part of this research and she was involved to promote health habits within the enrolled participants. This session was also one on one on the same day when the client visited the facility for nutrition counseling. This included counselling on mild to moderate exercises ( with a focus on walk of for 30 min). No monitoring was done but a follow up checklist based on the response of the participant in his/her next visit was filled to enusure whether he/she is following the intervention or not.. The intensity was assessed using a modified Borg scale 0-10. The exercises included a walk of atleast 30 min with step counter of atleast reaching a maximum of 10,000 steps and stretching exercises (resistance training) as convenient to them using videos from you tube. 3. Medication optimisation guidance: Diabetes medications were systematically adjusted throughout the trial based on glycemic response to lifestyle interventions. Participants were monitored regularly, and medications were reduced or discontinued by the study physician using a standardized algorithm when glucose levels improved. Priority was given to reducing medications with hypoglycemia risk (insulin, sulfonylureas) first. The goal was to maintain glycemic targets (HbA1c =7.0%) while minimizing medication burden and hypoglycemia risk. These interventions were employed using individual technique based on follow up visits.