Lifestyle interventions for adults with type 2 diabetes (T2D) are usually aimed at weight loss. However, some adults with T2D do not need to lose weight (about 15%). Also, many do not want to or cannot lose weight and keep it off. Another approach to T2D care is to prevent blood glucose levels becoming too high with meals. This is called “glycemic excursion minimization” or GEM. GEM works by identifying a person’s food choices that minimize glucose increases. It also finds physical activities that help an individual to lower their blood glucose levels.

Lowering blood glucose levels after meals

Recently, researchers reported the long-term results from a study comparing weight loss training with GEM in adults with T2D. Weight loss therapy involved six 60-minute group sessions focused on reducing calories and increasing physical activity. In contrast, GEM consisted of four 90 min group sessions focused on reducing mealtime glucose rises, educating participants on the impacts on glucose levels of different foods and physical activity, discouraging certain carbohydrates, and increasing routine physical activity and exercise after meals.

Look at glucose levels after meals to help people with T2D

GEM was equivalent to weight loss in reducing HbA1c by at least 0.5%. Additionally, 52% of participants responded to GEM vs. 42% response with weight loss education. GEM had additional benefits for participants compared to weight loss therapy. Benefits from GEM include:

  • Less carbohydrates consumed
  • Less diabetes medication taken
  • Less diabetes distress
  • Greater satisfaction with self-monitoring of blood glucose levels monitoring, good cholesterol (HDL) and body mass index (BMI) levels
  • Enhanced diabetes empowerment over 13 months

These findings suggest that, as an alternative to weight loss education, GEM is a brief, sustainable and effective lifestyle treatment option for adults with T2D. This may be especially relevant to patients who do not need or are unable to achieve long-term weight loss.


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