Subscribe to Dr. Meschino’s Free Newsletter

Subscribe Now

NMU 263 – Nutrition and Lifestyle Counseling Reverses Pre-Diabetes and Prevents Type 2 Diabetes Development

Nutrition/Natural Medicine Update No 263 (November 2, 2022)

with Dr. James Meschino

Topic: Nutrition and Lifestyle Counseling Reverses Pre-Diabetes and Prevents Type 2 Diabetes Development

Source: The Lancet Regional Health (Europe 2022)


Let’s talk about type 2 diabetes for a moment and the importance of nutrition and lifestyle counseling. Globally, there were 438 million cases of type 2 diabetes in 2019, with an age-standardized point prevalence of 5,283 per 100,000 people in the world.  This means that for every 100,000 people on the planet, over 5,000 people have type 2 diabetes as of the year 2019.  This represents a 49% increase since the year 1990. The reason for the increase is largely due to more people being overweight and less physically active, as we embrace the digital age. People with diabetes have an increased risk of developing a number of serious life-threatening health problems, which results in higher medical care costs, reduced quality of life, and increased mortality. Drugs alone have not solved the problem, thus far.

So, in Finland, they did something that is very logical and straightforward. They involved primary health care practitioners to deliver standardized nutrition and lifestyle counseling to over 2,900 prediabetic patients across the country. In the most successful arm of the study, patients were provided with a health app that prompted them to check off healthy dietary and lifestyle habits they accomplished throughout the day, as well as receiving group counseling sessions aimed at helping them make healthier food and activity choices. The stated aim was not to lose weight but to improve diet quality, increase physical activity, reduce sedentary time, improve sleep, reduce alcohol consumption, and stop smoking, thereby reducing the risk of their prediabetic condition from progressing to full-blown type 2 diabetes. The results showed that the group using the health app and receiving group counseling ate more vegetables and better-quality fats, and their waist circumference reduced slightly. As one of the lead researchers (Kirsikka Aittola) stated, “better diet quality reduces the risk for type 2 diabetes regardless of changes in the person’s weight”. Commitment to using the health app also increased physical activity and reduced sedentary time.

The findings of this study are important, as this is the first large, randomized, controlled study involving primary health care practitioners and studying interactions between the combined use of the digital app and group-based lifestyle counseling. I think this is an important message, as much of diabetes and pre-diabetes management focuses on prescription drug management. This large study shows the power of patient education, combined with motivation and adherence tracking using a digital device. Of course, digital health apps and devices are becoming increasingly popular. But the secret to enhanced success with health outcomes for many people appears to be to combine the use of health apps and devices with personalized wellness and nutritional medicine counseling. The human touch is still required to help many people make lifestyle changes that are in their best health interests. So, if you have pre-diabetes or type 2 diabetes, you may want to seek the help of a healthcare provider who can work with you to help facilitate nutrition and lifestyle changes and suggest the use of a health app to help track your daily success and increase your level of compliance. Reversing the global trend in type diabetes can be greatly aided by combining some existing health app technology with personalized nutrition and lifestyle coaching. These have been important missing ingredients in my view.

I have provided the references for this information in the text below.

Primary Reference:  Timo A. Lakka, Kirsikka Aittola, Elina Järvelä-Reijonen, Tanja Tilles-Tirkkonen, Reija Männikkö, Niina Lintu, Leila Karhunen, Marjukka Kolehmainen, Marja Harjumaa, Elina Mattila, Riia Järvenpää, Miikka Ermes, Santtu Mikkonen, Janne Martikainen, Kaisa Poutanen, Ursula Schwab, Pilvikki Absetz, Jaana Lindström, Jussi Pihlajamäki. Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk – A stop diabetes pragmatic randomised trialThe Lancet Regional Health – Europe, 2022;

Science Direct:

Type 2 Diabetes Worldwide Stats and Trends:,since%201990%20(Table%201)


Eat Smart, Live Well, Look Great,

Dr. Meschino

Facebook Comments