Diabetes remission is defined as Hba1c < 6.5 without medications for at least 3 months. This possibility and arena of diabetes remission research is growing at a rapid and exciting pace as more and more diabetics seek deeper solutions across the world.
We at the Freedom from Diabetes Research Foundation are committed to identifying, implementing and publishing holistic and sustainable methods for reversing diabetes, its complications (related to eyes, heart, kidneys, nerves, etc) and related metabolic disorders (related to obesity, high cholesterol, hypertension, hypothyroid, PCOD, etc)
Introduction The purpose of the study is to test the efficacy of Freedom from Diabetes (FFD) protocol on diabetic nephropathy patients.
Methods Out of 776 participants enrolled, 302 had diabetic nephropathy. Selected participants were given a specially modified plant based diet along with lymphatic movement, anti-gravity exercises and relevant supplements to reverse the effects of nephropathy. Baseline characteristics, anthropometric measurements and biochemical parameters were measured on visit 1 and visit 2.
Results - After 6 months, there was a significant reduction in urinary microalbumin and serum creatinine levels which was accompanied by improvement in glycemic control. Anthropometric measurements like body weight and BMI also showed a significant improvement.
Conclusion - This study states that FFD protocol (specifically adapted plant-based diet along with lymphatic movement and anti-gravity exercises) with relevant supplements helps in improving diabetic nephropathy status.
This study aimed to investigate the effectiveness of a specified diet pattern and exercise like lymphatic and strength-building exercises (FFD protocol) to enhance weight and fat loss. A 45-year-old male with a history of obesity and diabetes mellitus (DM) enrolled in the study. The patient followed a specified diet along with lymphatic and strength-building exercises. Follow up was done for 6 months where, baseline characteristics, anthropometric measurements and biochemical parameters were measured in visit 1 and visit 2. The patient was off DM medication in 10 days. In first follow up (3 months) weight, BMI, waist circumference and body fat was significantly reduced. Whereas skeletal muscle mass was increased. A drop in HbA1C, fasting insulin, fasting blood sugar level and postprandial blood sugar levels were observed. In comparison to first follow up the second follow up after 6 months, shows substantial changes in the basal parameters. A drastic decline in HbA1c was reported from 6.1% to 5.5%. The FFD program comprehensively targets diabetes, ultimately clearing GTT the harbinger of the defeat of diabetes and visceral obesity, thereby successfully reversing the cluster of components of this morbid syndrome.
Diabetes Mellitus is leading cause of morbidity and mortality in India with its increased prevalence. This study assessed the impact of 7 days residential program named Transcendental Residential Program (TRP) of Freedom From Diabetes Research Foundation (FFDRF) on type 2 diabetes mellitus participants as a complementary therapy to pharmacotherapy. A retrospective observational study was conducted on 485 diabetes mellitus participants after obtaining the informed consent where they underwent integrated training under a team consisting of doctors, cooking experts, nutritionists, fitness trainer and stress management trainer. TRP was intended to bring in changes in habit patterns related to the four modifiable factors namely diet, physical activity, medicines, and inner transformation (through stress release and developing positivity). After 7 days of the program there were statistically significant changes in the outcome variables like fasting blood glucose, postprandial blood glucose, weight and reduction in insulin and oral hypoglycemic medications. The results suggest the significance of a well-planned lifestyle modification program of FFD and its impact on the clinical outcomes in type 2 diabetes mellitus. This study has a major limitation such as there was no control group. However, TRP when used as an adjunct to pharmacotherapy has shown to improve glycemic control and reduce the requirement for medication within a short period of time. Given the fact, despite many advances in pharmacotherapy, diabetes mellitus and its complications are still escalating. Therefore, a personalized integrated health program that helps participants to make a shift in their current lifestyle is the way subsequently to reverse this life-threatening metabolic disorder.
To test the hypothesis that specifically modified plant-based diet and anti-gravity exercises in Type 2 diabetics followed for a period of 10-14 weeks improves the glycemic control and reduces requirement of anti-diabetic medication. Around 386 confirmed diabetic participants enrolled in this study. Out of these 259 participants completed the study. This was a follow up study for a period of 10-14 weeks where the anthropometric measurements and biochemical parameters were measured at week 0 and at week 10-14 weeks. Medication was also monitored daily based on the blood glucose levels and change in medication was noted at the end of 10-14 weeks. After 10-14 weeks of consumption of modified plant-based diet and anti-gravity exercises was accompanied by a significant reduction in anthropometric measurements like body weight (p=0.0001*), BMI (p=0.0001*), fat percentage (p=0.0003*) and visceral fat percentage (p=0.0002*). Lower anthropometric measurements were accompanied by a reduction in HbA1C (p=0.000*), fasting (p=0.038*) and postprandial (p=0.000*) blood glucose levels. A reduction in the dosage and number of participants requiring oral hypoglycemic agents (OHA) and insulin was observed due to improved glycemic index. In the diabetic study population, intervention with modified plant-based diet and anti-gravity exercises was associated with an improved glycemic control and reduced requirement of antidiabetic medications. These findings may assist in development of a standard integrated protocol for treating diabetic patients thus reducing the pre-disposition to diabetic complications thus preventing or prolonging the onset of diabetes complications.
The following case series documents six patients consulted in the Freedom From Diabetes Research Foundation (FFDRF) in Pune, India, for the treatment of type 2 diabetes mellitus (DM). This study aims to determine the effectiveness of a specifically modified plant based diet combined with anti-gravity exercises (FFD protocol) towards the cessation of the use of oral hypoglycemic agents (OHAs) and/or external insulin to control blood glucose levels and have the ability to clear the Glucose Tolerance Test (GTT). The patients selected for the study had a minimum of 10 years diabetes. Four of them were only on OHAs and two were on external insulin and OHAs. They had followed the FFD protocol and were included in this study only after fulfilling the following parameters- latest average glycated hemoglobin (HbA1C) levels less than 6.5 and not taking any OHAs or insulin for the last 3 months. Initial and latest demographic data was collected. This included weight, waist circumference, fasting blood glucose levels and HbA1C levels. All 6 patients showed a major improvement in the HbA1C levels, loss in body weight and reduction of waist circumference. In conclusion to this case series, these patients were able to undergo and clear the GTT. This study shows that all these patients have reached an advanced stage of diabetes reversal; besides becoming free from any kind of medications, they are also able to handle a 75 gram glucose load with ease. This would have been otherwise impossible for them. Such results are an important milestone in the history of type 2 diabetes mellitus management and give immense hope to diabetics, their family members, diabetes educators, doctors and the world at large.
Background: Type 2 diabetes (T2DM) remission is widely reported across the world. However, there are no large-scale cohort studies, especially in Indian population.
Aim: To evaluate the effectiveness of a structured community-based lifestyle modification program- ‘Freedom from diabetes holistic transformation program (FFD-HTP) on T2DM remission in Indian population.
Materials and methods: Patients with diagnosed T2DM (HbA1C > 6.5 or on conventional diabetes medication) above 18 years of age were included in a one-year intense lifestyle modification program, ‘FFD-HTP’. The intervention includes dietary modifications (high protein, low carbohydrate vegan diet, with low glycemic fruits and vegetables), personalized exercise plan (anti-gravity, yoga poses, cardio workout), and stress management support (psychological counselling, mindfulness meditation), with regular monitoring through a personal mentor. HbA1C and other biochemical parameters were measured at baseline, every three months, and after completion of the study, while fasting and post prandial blood glucose levels were measured daily. Complete T2DM remission was defined as maintaining HbA1c<6.5 for at least 3 months without use of anti-diabetic medication.
Results: A total of 3,103 patients were screened between December 2020 and March 2021. Of these, 1,127 (699 males) met the inclusion criteria. Mean age was 51.7±10.4 years with mean duration of diabetes 10.4±7.6 years. After one-year intervention, 416 patients (36.9%) achieved T2DM remission. Patients were divided into four groups: Groups A (on oral hypoglycemic agents [OHA], n=829), B (on both insulin and OHA, n=219), C (only on insulin, n=4), and D (not on any anti-diabetic medication, n=75), respectively. In group A 41.7% (n=346) patients, group B 5.9% (n=13) patients, and group D 76% (n=57) patients achieved complete remission, with no remission in group C.
Conclusion: Our findings tentatively suggest that FFD-HTP is beneficial in achieving T2DM remission in Indian population. A one-year post-intervention follow-up is underway to understand the long-term effects of the intervention.
Background: Type 2 diabetes (T2DM) is a chronic metabolic disorder that has a significant impact on mental health of an individual. In turn, depression and anxiety result in poor disease outcome and early mortality in patients with T2DM.
Objective: The study aimed to assess the effect of holistic lifestyle intervention in improving depression and anxiety in patients with T2DM.
Materials and Methods: In this quasi-experimental study, baseline data on 250 T2DM patients enrolled in a one-year online holistic lifestyle intervention programme at the Freedom from Diabetes Clinic (Pune, India) between May-August 2021 was collected. Data on anthropometric parameters and medical history was collected along with response to validated Patient Health Questionnaire (PHQ-9) (scoring 0-27) and Generalized Anxiety Disorder Assessment (GAD-7) scale (scoring 0-21). The intervention comprised of customized vegan diet and exercise protocol along with following activities to improve mental health: meditation, diary writing, goal setting, and one-on-one psychological counselling sessions. At the completion of 6 months of intervention, the patients were re-administered the questionnaires to see the effect in improving the PHQ-9 and GAD-7 scores. Since the intervention is for one year, data collection is ongoing.
Results: At baseline, the prevalence of depression and anxiety (score>10) was 13% and 15% which reduced to 9.3% and 8.9% post-intervention, respectively. Post intervention, depression (3.30+4.35) and anxiety scores (3.27+4.21) were statistically lower than baseline (4.28+4.49 & 4.59+5.16) (Z= -3.73; -4.25, p<0.05) , respectively (using Wilcoxon signed rank test). Of the 32 patients with depression and 38 patients with anxiety at baseline, those who regularly attended the inner transformation phase and one-on-one psychological counselling session /s, 10 showed an improvement in depression scores and 20 showed improvement in anxiety scores.
Conclusion: Our findings suggest that incorporating a psychological component to lifestyle interventions may help improve mental health in patients with T2DM.
Background & Aim: Weight loss-induced Type 2 Diabetes (T2D) remission is widely reported in overweight and obese but not in those with normal BMI. Indians are known to have higher body fat at normal BMI. The study aimed to evaluate the effectiveness of a one-year lifestyle modification program on weight-loss-induced T2D remission in non-obese Indian population.
Materials and methods: We retrospectively analyzed data on anthropometric and biochemical parameters of T2D patients (with prior informed consent) with normal BMI (18.5 to 25 kg/m2) enrolled in an online one-year diabetes management program. The intervention included a customized plant-based diet, exercises, stress management, and medical support. Remission was defined as HbA1c<48 mmol /mol for a minimum of 3 months without the use of anti-diabetic medications.
Results: The mean age, duration of diabetes, and BMI at baseline were 41.8±12 years, 10.6±11.9 years, and 22.8±2.3 kg/m2, respectively (n=515). Post-intervention, mean weight, fasting blood glucose, fasting insulin, and HbA1c decreased significantly (p<0.05). Remission was seen in 69 (13.3%) patients. Higher remission was seen in those with>5% weight loss and diabetes duration <6 years (36.2%) followed by those with <5% weight loss and <6 years of diabetes duration (26.8%). Those with >6 years of diabetes duration showed lower remission irrespective of the weight loss.
Conclusion: Our findings suggest that patients with normal BMI with recently diagnosed T2D can also achieve remission through lifestyle management with a weight loss of at least 5%. However, the rate of remission is lower in patients with normal BMI compared to that reported in overweight and obese patients in previous studies in the Indian population.
Background: The common factors influencing Type 2 diabetes (T2D) remission include the recent diagnosis, lower age, and minimal dosage of medicines. The current case study reports sustained T2D remission post-one-year lifestyle intervention program in an elderly male on a high dose of insulin.
Case presentation: An elderly male patient (60 years) with obesity (BMI 31.7 kg/m2) and diagnosed with T2D (3.4 years back) enrolled for a one-year lifestyle intervention program at our diabetes management clinic. At the first consult, he was on 94 units of insulin and oral hypoglycemic agents with an HbA1c of 8.7%. Other significant history included microalbuminuria (106 µg/ml). The intervention included a customized plant-based diet, exercises, stress management, and medical support. At the end of the program, he had a weight loss of 13 kg, stopped both insulin and OHAs, showed significant improvement in HbA1c (4.9% without medication) and urine microalbumin (3.2 µg/ml), and successfully cleared the 75g oral glucose tolerance test (OGTT). He continues to be in remission and has cleared the OGTT for 3 consecutive years.
Conclusion: We present three unique features in the current case report: (1) The elderly age of the patient and high insulin dosage, (2) OGTT clearance along with normalization of HbA1c, and (3) reversal of associated co-morbidity. The current case study shows that despite older age and higher dosage of insulin, the patient achieved complete T2D remission through sustained weight loss by following our lifestyle modification program. Future experimental studies with adequate sample sizes would help substantiate our observation.
Background: Weight loss through lifestyle modifications is known to induce Type 2 diabetes (T2D) remission; however, in recently diagnosed younger populations. Here we report the complete remission (defined as maintaining HbA1c <6.5% for at least three months without the use of diabetes medication) in an elderly patient with a 30-year history of T2D, through customized lifestyle modification.
Case Presentation: In December 2019, a 66-year-old male patient diagnosed with T2D (HbA1c 7.7%) and on both insulin and oral hypoglycemic agents (OHA) presented to our clinic. Other medical history included hypertension, hyperlipidemia, and multiple surgeries. Family history revealed that the patient’s mother had T2D. He enrolled in our one-year lifestyle modification program which included a customized plant-based diet, exercises, stress management, and medical management support. The patient underwent complete remission with a reduction in HbA1C (5.3%), fasting insulin (8.62 μU/ml), fasting blood sugar (85mg/dl), postprandial blood sugar (104mg/dl), and homeostatic model assessment of insulin resistance (HOMA-IR) (6.22 to 1.81) at the end of the program. He also successfully cleared the 75g oral glucose tolerance test (OGTT). The patient continues to be in remission based on his last follow-up visit in May 2022 (HbA1C 5.3%). Informed consent was obtained from the patient for reporting the case study.
Conclusion: We present three unique features in the current case report: 1) The patient’s advanced age, 2) longer duration of diabetes, and 3) HbA1c normalization with OGTT clearance. Younger age and lower diabetes duration are common positive predictors of T2D remission documented in earlier studies. The current case study shows that despite older age and longer T2D duration, it is possible to undergo complete remission along with OGTT clearance through lifestyle modification. Future planned studies with adequate sample sizes would help substantiate our findings.
Background & Aim: Type 2 diabetes (T2D) is a chronic metabolic disorder that has a significant impact on the mental health of an individual, which in turn results in increased morbidity and mortality. Aim of the present study was to assess the prevalence of anxiety and depression and its determinants in patients with T2D attending a diabetes management clinic in India.
Materials and Methods: Patients enrolling for a one-year online diabetes management program in India between July 2021 and September 2022 were invited to participate in this cross-sectional study. Data on medical history, anthropometry, and biochemical parameters were collected. The validated Patient Health Questionnaire (PHQ-9) (scoring 0-27) and Generalized Anxiety Disorder Assessment (GAD-7) scale (scoring 0-21) were used to assess depression and anxiety, respectively. Statistical analyses were performed using SPSS 21. P-value<0.05 was considered statistically significant.
Results: A total of 2730 (34.5% females) patients with T2D agreed to participate (gave informed consent) and completed the questionnaires. The mean age and duration of diabetes were 49.9±10.2 and 10.0±7.0 years, respectively. The prevalence of moderate to severe depression and anxiety was 20.3% and 17.3%, respectively. Both depression and anxiety were significantly higher in females, those who were overweight and obese, those who were less than 50 years of age, had recently been diagnosed (<6 years), those with poor glycemic control (HbA1c> 8%), and those on insulin (p<0.05). Conclusion: Gender, higher BMI, lower age, recent diagnosis, use of insulin, and poor glycemic control were factors affecting both anxiety and depression in T2D patients in India. The high prevalence of both depression and anxiety suggests the inclusion of psychological aspects in the management of T2D in the Indian population.
Glucose Tolerance Test (GTT) involves consuming 15 tsp (75 grams) of glucose in a fasting state. This is followed by checking Blood Sugar Level (BSL) tests, taken after one and two hours respectively. Only those whose BSL counts fall within normal ranges are declared successful. All diabetics usually fail this test. Infact, this test is used to diagnose diabetes and pre-diabetes. Many medical professionals consider it to be one of the ultimate test of reversal.
Over the years the number of FFD participants who have successfully cleared this test has grown tremendously, after becoming free of medications and coming into remission (Hba1c < 6.5 without medications for 3 months).
In 2015, we had around 15 GTT cleared participants; By 2021 that number had blossomed to 350+. So far, over 600+ participants have cleared GTT and 400+ have cleared IGT. Conventional thinking may maintain that diabetes is irreversible, but we know this is not true through this real-world experience. It’s a great achievement for anyone who has suffered from diabetes, to stop medications, to experience remission and then clear this tough test and it definitely is a cause of celebration. Summary of the year-wise results are given in the graph below:
Every year since 2015, we have been celebrating this achievement of our participants through a unique Festival of Freedom called Muktotsav. This is an annual event when our champions step into the well-deserved limelight. They are felicitated and awarded for their achievements. Not just those who have reversed their diabetes, and passed the GTT, but other champions too. For instance, people who have lost the maximum weight, or stopped their medicine in the shortest time. There are also award categories for freedom from hypertension, cholesterol medications, most deserving athletes, healthy couples and families, etc. The successes of our participants validate our efforts and our belief that Diabetes Can Be Reversed. This event greatly encourages other diabetics, from all over the world, to strive towards their own reversal and freedom!
Muktotsav has attracted several celebrity guests. In 2020, Muktotsav had internationally celebrated diabetes reversal pioneer, Dr. Neal Barnard as Chief Guest. In 2021, acclaimed researcher in the field of diabetes remission, Dr. Roy Taylor graced the event as the Chief guest along with Dr. Bhushan Patwardhan (Former Vice Chairman- UGC and Chairman- Indian Council of Social Science Research).
To know more about the people who have achieved this stupendous success, the celebrations and awards, please click on the year wise links below: