Grant: CIHR Fellowship

Type 2 diabetes (T2D) used to be considered a lifelong disease, but we now know that it can be reversed and put into remission. It has been demonstrated that in order for reversal of T2D to occur, pancreatic beta cell function and insulin sensitivity must improve. Reductions in pancreatic and liver fat through dietary strategies lead to improved beta cell function and liver insulin sensitivity, respectively. Furthermore, exercise is known to improve muscle insulin sensitivity. Taken together, a prescription of diet and exercise could lead to improvement in the underlying drivers of T2D and eventual reversal/remission of the disease. Although diet and exercise are currently recommended by Diabetes Canada, these recommendations are essentially the same as the recommendations for the general public and have never been assessed for their ability to impact the underlying drivers of T2D (i.e., pancreas and liver fat, insulin resistance). As the ideal goal for T2D treatment shifts from management to reversal, diet and exercise recommendations should reflect this shift. Because of underlying metabolic dysfunction in T2D, it is possible that current guidelines based on the general public may be insufficient to achieve meaningful improvements in the disease. This study will test the hypothesis that current diet recommendations, alone and in combination with current physical activity guidelines will improve metabolic health and disease status in people with T2D using a high-quality research design and state of the art measurement techniques. In addition, this study will investigate the effect of increasing the amount of exercise to determine if current exercise recommendations need to be increased. These results will directly inform the diet and exercise recommendations for people with T2D to ensure that current guidelines have a meaningful impact on T2D status.