This study is a real-world, prospective clinical cohort study. It will enroll Chinese patients with type 2 diabetes. The aim is to assess the changes in aging biomarkers, primarily DunedinPACE, from baseline to post-remission, and to compare these biomarkers between patients who achieve successful remission and those who do not.
This prospective real-world cohort study will enroll 100 Chinese patients with type 2 diabetes, aged 35-70 years. All participants will receive a 24-week multimodal intervention comprising caloric restriction, dietary counseling, exercise training, and adjustment of glucose-lowering medications. DNA methylation levels will be assessed using the Illumina Epic array to calculate the epigenetic aging clock (DunedinPACE), enabling evaluation of changes in biological aging from baseline to 24 weeks, as well as comparisons between patients with and without successful remission. In addition, changes in inflammatory cytokines, metabolic parameters, body composition, and other aging-related biomarkers will be monitored. The findings are expected to provide novel evidence for the benefits of type 2 diabetes remission.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Participants will receive a 24-week comprehensive lifestyle intervention: 1. Individualized calorie-restricted low-carbohydrate diet: 800-1000 kcal/day if body weight \<80 kg, or 1000-1200 kcal/day if ≥80 kg; each meal includes \~200 g vegetables and \~100 g lean protein, with low fat/sugar/salt; avoid high-fat meats and organ foods; daily food weighing and recording required. 2. Aerobic exercise ≥150 min/week at moderate intensity (50-70% of maximal heart rate) plus 2-3 resistance training sessions weekly. 3. Monthly nutrition clinic visits for dietary adjustment. 4. Self-monitoring of weight and fasting glucose ≥2 times/week; monthly in-person follow-ups for the first 6 months. 5. Hypoglycemic agents: baseline doses maintained; if fasting glucose \<7 mmol/L and 2-h postprandial glucose \<10 mmol/L, reduce 1-2 drug types per step; hypoglycemia episodes managed by investigator for dose reduction or discontinuation.
Change in DunedinPACE epigenetic clock from baseline to 24 weeks.
DunedinPACE is derived from Illumina Epic DNA methylation data. The change score is compared between participants with and without diabetes remission (remission defined as HbA1c \<6.5% off glucose-lowering drugs for ≥3 months).
Time frame: Baseline to 24 weeks
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