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The PB+Ex intervention included 12 weeks of meals, exercise sessions and group classes. Primary outcomes were glycaemic control (HbA<jats:sub>1c<\/jats:sub>, glucose, insulin and HOMA-IR) and glucose-lowering medication use. Secondary outcomes included lipids, blood pressure, heart rate and C-reactive protein. Only lab analysts were blinded.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Compared with SMC (<jats:italic>n<\/jats:italic>=90 randomised; <jats:italic>n<\/jats:italic>=70 analysed), the PB+Ex (<jats:italic>n<\/jats:italic>=79 randomised; <jats:italic>n<\/jats:italic>=66 analysed) intervention decreased HbA<jats:sub>1c<\/jats:sub> by an additional 14 mmol\/mol (1.3%) at week 12 (\u221222 vs \u22127 mmol\/mol [\u22122.0% vs \u22120.7%]; <jats:italic>p<\/jats:italic>&lt;0.0001) and 8 mmol\/mol (0.7%) at week 24 (\u221216 vs \u22128 mmol\/mol [\u22121.4% vs \u22120.7%]; <jats:italic>p<\/jats:italic>=0.01). Concomitantly, 63% of medicated PB+Ex participants reduced their glucose-lowering medications (vs 24%; <jats:italic>p<\/jats:italic>=0.006), and 23% of PB+Ex participants with a baseline HbA<jats:sub>1c<\/jats:sub> &lt;75 mmol\/mol (&lt;9%) achieved remission. Additionally, the PB+Ex intervention reduced weight (\u22122.7 kg; <jats:italic>p<\/jats:italic>&lt;0.0001), C-reactive protein (\u221211 nmol\/l; <jats:italic>p<\/jats:italic>=0.005) and cardiovascular medication use compared with SMC. At intermediate timepoints, it improved glucose, insulin, HOMA-IR, cholesterol, triglycerides and heart rate, but not at week 24.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\/interpretation<\/jats:title>\n            <jats:p>A whole-food, plant-based lifestyle intervention was more effective for improving glycaemic control than SMC. It also reduced the need for diabetes and cardiovascular medications and induced diabetes remission in some participants. Therefore, it is an effective, evidence-based lifestyle option for individuals with type 2 diabetes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>ClinicalTrials.gov NCT03862963<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Funding<\/jats:title>\n            <jats:p>This research was funded by the Department of the Army (W81XWH-05-1-0547). CJH received support through a National Institutes of Health Predoctoral T32 Obesity Fellowship (T32 HL105349).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00125-024-06272-8","type":"journal-article","created":{"date-parts":[[2024,9,21]],"date-time":"2024-09-21T11:01:29Z","timestamp":1726916489000},"page":"308-319","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["A whole-food, plant-based intensive lifestyle intervention improves glycaemic control and reduces medications in individuals with type 2 diabetes: a randomised controlled trial"],"prefix":"10.1007","volume":"68","author":[{"given":"Cody J.","family":"Hanick","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney M.","family":"Peterson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda C.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Sabat\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"John H.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,9,21]]},"reference":[{"issue":"1","key":"6272_CR1","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","volume":"10","author":"MAB Khan","year":"2020","unstructured":"Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J (2020) Epidemiology of type 2 diabetes - global burden of disease and forecasted trends. 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Spence, President and Co-founder of Canvasback Missions, Inc., served as Principal Investigator, secured federal funding, recruited research staff, and administered the project alongside Jacqueline L. Spence, Vice President and Co-founder, who served as CFO.Special thanks to Hak Jae Chung, on-site administrator for Canvasback Missions, and Ralph D. Harris (former physician at The Meridian Senior Retirement Center).Deepest gratitude is extended to the government of the Republic of the Marshall Islands, particularly the Ministry of Health, for providing Marshallese staff and medical professionals, sample processing and a vacant building that Canvasback Missions built out into the Canvasback Diabetes Wellness Center. Thanks to the RMI Diabetes Wellness Clinic for their assistance in recruitment and medical care for SMC participants.An abstract and a research poster were presented virtually at the American Diabetes Association\u2019s 82nd Scientific Sessions on 3 June 2022.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"The datasets generated during and\/or analysed in the current study are available from the corresponding author upon reasonable request.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Open access funding provided by SCELC, Statewide California Electronic Library Consortium. The study was supported by the U.S. Army Medical Research Acquisition Activity (USAMRAA) under award number W81XWH-05-1-0547. The content is solely the responsibility of the authors and does not necessarily represent the official views of the U.S. Army. Additional funding for the study was provided by Canvasback Missions, Inc.\u00a0CJH received support through a National Institutes of Health Predoctoral T32 Obesity Fellowship (T32 HL105349). The content is solely the responsibility of the authors and does not necessarily reflect the views of the National Institutes of Health.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"BCD is the author of the books Defeating Diabetes and The Kick Diabetes Cookbook: An Action Plan and Recipes for Defeating Diabetes. The authors declare that there are no other relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"JHK designed the study, with input from JS. BCD and JHK conducted the study, including designing the menus, administering the intervention and acquiring data. CJH and CMP performed the statistical analyses and drafted the manuscript. All authors interpreted study data and revised and approved the final version of the manuscript. JHK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}