Intensive Lifestyle Intervention in Patients With Insulin-treated Type 2 Diabetes: a Pilot Project

Inclusion criteria: 1. Age 18 to 75, BMI 27 to 45 kg / m2 2. Diagnosed T2DM 3. Insulin-treated for a minimum of 5 years 4. Having a glycated hemoglobin \<9.5% (HbA1c dating ≤3 months) 5. Having internet and telephone access to enable monitoring of the intervention and remote blood glucose monitoring 6. If treated with a glucagon like peptide-1 (GLP-1), must be on a stable dose for a minimum of 6 months 7. Having good autonomy in managing medication (including insulin) and preparing meals. Exclusion criteria: 1. A diagnosis of T2DM with a tendency to ketosis 2. A history of ketoacidosis associated with taking an SGLT2 inhibitor 3. Medical history of eating disorders 4. Severe hypoglycemia in the past year or decreased perception of hypoglycemia determined by Clarke's method with a score ≥ 4 (17) 5. A history of gastrointestinal tract surgery that alters the ability to absorb nutrients (weight loss surgery, short bowel, etc.) \[cholecystectomy or appendectomy are not exclusion criteria\] 6. A history of pancreatic insufficiency, advanced liver disease or liver transplant \[Hepatic steatosis is not an exclusion criterion\] 7. Active cancer under treatment or a history of cancer with active treatment in the past year (basal cell carcinoma is not an exclusion criteria) 8. Daily fluid restriction 9. A pregnant / breastfeeding participant, wishing to be pregnant during the study period or having given birth less than one year before the start of the study 10. The presence of advanced complications of T2DM (renal failure with estimated glomerular filtration rate \<30 ml / min / 1.73m2, proliferative diabetic retinopathy, severe neuropathy) 11. Drug or alcohol use in the past 12 months. Defined by more than 2 drinks per day or more 10 per week for women, and more than 3 drinks per day or more than 15 per week for men. 12. Advanced fragility (See the score which is in the recommendations of Diabetes Canada chapter elderly people) 13. A macrovascular episode (heart attack, stenting, coronary bypass surgery or stroke less than 6 months ago. 14. An active wound Additional to the inclusion/exclusion criterias, the PI will determine the inclusion of the participant to the study.