Article 2026-04-21 under-review v1

Lifestyle intervention outcomes in T2DM and the added value of CGM: 6-month results from the Polish cohort of the C4D study

J
Joanna Ostrowska Medical University of Warsaw
E
Ewa Kobos Medical University of Warsaw
M
Mariola Pietrzak Medical University of Warsaw
A
Agata Szymczak National Health Fund Headquarters
K
Katarzyna Wiktorzak National Health Fund Headquarters
M
Marta M. Pisano-González Ministry of Health of the Principality of Asturias (CSPA)

Abstract

Background Type 2 diabetes remains a major public health challenge, requiring lifelong management. Structured lifestyle-based interventions are increasingly recognised for their role in supporting self-management. The CARE4DIABETES (C4D) programme, part of a Joint Action funded by the EU4Health initiative, aims to implement and evaluate a behavioural lifestyle model (Reverse Diabetes2 Now) across 12 European countries.Methods C4D is a 12-month, quasi-experimental, structured, digitally supported lifestyle programme comprising multiple group-based educational sessions delivered by a multidisciplinary team (MDT) and addressing nutrition, physical activity, sleep, and stress management. This interim analysis includes the Polish cohort (n = 38; type 2 diabetes duration ≤ 10 years), presented overall and stratified by continuous glucose monitoring (CGM) users (n = 21) versus self-monitoring of blood glucose (SMBG, n = 17).Results At 6 months, participants showed significant improvements. Mean HbA1c decreased by 0.78 percentage points (–10.9%; p < 0.001) to 6.35%. Body weight decreased by 6.04 kg (–6.5%; p < 0.001), waist circumference by 6.77 cm (–6.4%; p < 0.001), fat mass by 2.47 kg (–7.2%; p < 0.001), and triglycerides by 20.3% (p = 0.023), while total cholesterol, LDL-C, and HDL-C did not change significantly. Improvements were numerically larger in the CGM group. Between-group comparisons of change scores showed greater reductions in body weight and BMI in the CGM group compared with the SMBG group (p < 0.05; Cohen’s d ≈ 0.9–1.0).Conclusion The 6-month intensive phase of this structured, group-based lifestyle education programme was associated with clinically meaningful improvements in glycaemic control and anthropometric outcomes. Improvements were greater among CGM users than in the SMBG group, suggesting that integrating CGM into structured education may further enhance programme outcomes.

Citation Information

@article{joannaostrowska2026,
  title={Lifestyle intervention outcomes in T2DM and the added value of CGM: 6-month results from the Polish cohort of the C4D study},
  author={Joanna Ostrowska and Ewa Kobos and Mariola Pietrzak and Agata Szymczak and Katarzyna Wiktorzak and Marta M. Pisano-González},
  journal={Scientific Reports},
  year={2026},
  doi={https://doi.org/10.21203/rs.3.rs-9169658/v1}
}
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