Introduction and Objective: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduce weight and improve glycemic control in type 2 diabetes mellitus (T2DM). However, discontinuation often leads to weight regain and worsening metabolic markers. This study evaluates whether structured lifestyle management can sustain improvements after GLP-1 deprescription (DeRx) compared to continued GLP-1 therapy.Methods: A total of 392 participants with T2DM initially received GLP-1 therapy for 48 weeks. Post initial therapy, Cohort 1 (C1, n=130) received GLP-1 DeRx with continued lifestyle management via Breathe Well-being’s interventions on nutrition, fitness, and mental health through remote monitoring and care, Cohort 2 (C2, n=131) received GLP-1 DeRx without further intervention, and Cohort 3 (C3, n=131) remained on GLP-1 for an additional 52 weeks. Weight, HbA1c, and cardiometabolic markers were assessed at baseline, 48 weeks (end of initial therapy for C1 and C2), and 100 weeks.Results: At 48 weeks, all groups had similar improvements: 12.1% weight loss and 2.8% absolute HbA1c reduction for C1, 12.3% weight loss and 2.9% absolute HbA1c reduction for C2, and 11.9% weight loss and 2.6% absolute HbA1c reduction for C3. At 100 weeks, C1 maintained 11.3% weight loss and 2.6% HbA1c reduction (while 85% remained below 6.5%) and retained cardiometabolic benefits. C2 regained 9.1% of lost weight (in absolute terms), observed HbA1c rising by 2.1%, and saw metabolic markers revert toward baseline. C3 sustained the greatest improvements, maintaining 12.1% weight loss, 2.9% HbA1c reduction, and superior cardiometabolic outcomes.Conclusion: Lifestyle management after GLP-1 deprescription helps sustain health benefits and Breathe Well-being’s approach offers a sustainable alternative for long-term weight and glucose management, reducing medication dependence.
A. Kaicker: None. P.K. Goyal: None. R. Verma: None. S. Goel: None.
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