With the help of a simple lifestyle modification program, can people newly diagnosed with type 2 diabetes manage their condition without medication? A new study at the University of Virginia School of Medicine aims to find out.

The study is evaluating a program known as Glycemic Load, Exercise and Blood Glucose, or GLEBG. The program is built on education and informed decision-making, with an emphasis on simplicity, sustainability, satisfaction and safety. It aims to help users:

• learn about diabetes, food and physical activity;
• select foods that don’t spike blood glucose;
• increase their physical activity;
• and adopt healthy behaviors by understanding how their choices affect their blood sugar.

Unlike other programs, GLEBG requires no structured exercise program, no carbohydrate or calorie counting, no special foods and no disruption of users’ daily routines. Instead of focusing on what people can’t eat or shouldn’t do, it focuses on the foods they can enjoy and the steps they can take to manage their diabetes.

“Type 2 diabetes is an exploding epidemic,” said U.Va. researcher Daniel Cox, noting that there are now more than 24 million people with the condition. “In this study, we’re teaching people how to use blood sugar monitoring to learn how their body responds to different types of food, different types of physical activity. … We don’t tell people what to do, we help them make decisions.”

School of Nursing professor Ann Gill Taylor, co-investigator on the project, added, “We are all about wanting patients to have better tools to make informed health care decisions.”

Co-investigator Dr. Anthony McCall said, “We are trying to help people understand what to do when their blood sugars rise and how to prevent this from continuing to occur.”

Study participants will be divided into two groups, one group receiving routine medical care and the other following the GLEBG program. Participants will receive blood glucose monitors and supplies to monitor their blood sugar levels for six months. The U.Va. researchers will then compare the two groups’ outcomes, evaluating the effectiveness of the GLEBG program against that of the typical diabetes management.

“The hypothesis being tested,” McCall said, “is whether knowing how to manage and prevent high blood sugars will lead to better overall health risks without medication.”

Ultimately the GLEBG program aims to help users avoid blood sugar spikes and use glucose more efficiently. The latter is done both by burning glucose directly, through physical activity, and indirectly, by improving insulin sensitivity.

While the program’s focus is on diabetes management, the U.Va. researchers are also eager to see if the program produces additional health benefits, such as weight loss and improved cardiovascular health.

“It’s an integrated package designed not to tell people what to do, because that’s a formula for failure, but to help people to make choices and know the cost of those choices,” Cox said. “So if they want to have a piece of apple pie, they can have a piece of apple pie. But they should know the cost to their health and decide whether or not that piece of apple pie is worth it.”