According to Gram Research analysis, a lifestyle program adapted from the Netherlands and tested in Belgium helped 43% of people with type 2 diabetes reduce their medication needs within 12 months. The Care4Diabetes program, which combined five group education sessions with individual check-ins over 6 months, reduced blood sugar levels by 0.49% at 6 months and helped participants lose an average of 3.6 kilograms. Nearly half of participants maintained stable blood sugar control without needing additional medications, suggesting lifestyle interventions can meaningfully reduce medication burden in primary care.
Researchers in Belgium tested a lifestyle program called Care4Diabetes that was originally developed in the Netherlands to help people with type 2 diabetes manage their condition better. The program combined group classes and one-on-one check-ins focused on healthy eating and lifestyle changes. After 12 months, nearly half the participants didn’t need to increase their diabetes medications, and 43% actually needed less medication. Participants also lost weight and reported feeling healthier overall. The study shows this program can work well in Belgium and might help reduce the burden of diabetes in Europe.
Key Statistics
A quasi-experimental study of 43 Belgian adults with type 2 diabetes found that 43% required less diabetes medication after completing the 12-month Care4Diabetes program, while 46% maintained the same medication level.
The Care4Diabetes program reduced blood sugar levels (HbA1c) by 0.49% at 6 months in a 2026 Belgian study of 43 participants, with participants achieving an average weight loss of 3.6 kilograms by month 12.
In a 2026 implementation study of 43 people with type 2 diabetes in Belgium, the adapted Dutch Care4Diabetes program achieved high satisfaction rates from both participants and healthcare providers, demonstrating good transferability to Belgian primary care settings.
A 2026 Belgian study found that among 43 participants with type 2 diabetes, only 11% required intensified medication after completing the Care4Diabetes lifestyle intervention, while 89% either reduced or maintained their medication levels.
The Quick Take
- What they studied: Whether a Dutch diabetes lifestyle program could work in Belgium and help people with type 2 diabetes reduce their need for medications while improving their health
- Who participated: 43 Belgian adults with type 2 diabetes in two primary care clinics in Wallonia (the French-speaking region of Belgium). 37 people completed the full 12-month program.
- Key finding: After 12 months, 43% of participants needed less diabetes medication, 46% needed the same amount, and only 11% needed more. Blood sugar control improved significantly at 6 months, and participants lost an average of 3.6 kilograms.
- What it means for you: If you have type 2 diabetes, lifestyle changes through structured programs like this may help you reduce your medication needs. However, this was a small study, so larger research is needed before making major changes to your diabetes care plan. Always talk to your doctor before changing medications.
The Research Details
This was a quasi-experimental study, which means researchers tested the program in real-world primary care clinics rather than in a controlled laboratory setting. The study took place in two clinics in Wallonia, Belgium, and followed 43 people with type 2 diabetes for 12 months.
The Care4Diabetes program had two phases. In the first 6 months, participants attended five group sessions focused on different topics like healthy eating and physical activity, plus one individual meeting with a healthcare provider. From months 6 to 12, participants had one more check-up and attended a refresher session to help them maintain their progress.
Researchers measured several things: blood sugar control (HbA1c), how much diabetes medication people needed, weight, cholesterol levels, eating habits, and how people felt about their overall health. They used statistical methods to track changes over time and account for the fact that some people changed their medications during the study.
Testing programs in real primary care clinics (rather than research labs) is important because it shows whether something actually works when doctors and patients use it in everyday life. This approach helps researchers understand if a successful program from one country can work in another country with different healthcare systems and cultures. The study also tracked medication changes, which is crucial because reducing unnecessary medications is a major goal in diabetes care.
Strengths: The study tracked people for a full year, which is long enough to see real changes. Most people who started the program finished it (37 out of 43), which suggests it was acceptable to participants. Healthcare providers reported high satisfaction with the program. Limitations: The study was small with only 43 participants, so results may not apply to all Belgian people with diabetes. There was no comparison group of people who didn’t do the program, making it harder to know if improvements were due to the program or other factors. The study was conducted in only one region of Belgium, so results may differ in other areas.
What the Results Show
The most important finding was that participants significantly reduced their need for diabetes medications. At the 12-month mark, 43% of participants needed less medication than they started with, 46% stayed on the same amount, and only 11% needed more medication. This is encouraging because reducing medication burden is a major goal in diabetes care.
Blood sugar control, measured by a test called HbA1c, improved significantly at the 6-month mark, dropping by 5.4 mmol/mol (which equals a 0.49% decrease). However, this improvement was smaller at 12 months, decreasing by 2.8 mmol/mol (0.26%). When researchers looked only at people who didn’t change their medications, the improvements stayed strong at both time points, suggesting the program itself was helping control blood sugar.
Participants also lost weight, with an average loss of 3.6 kilograms by month 12. This weight loss is important because it helps improve insulin sensitivity and overall metabolic health. Additionally, people reported eating healthier foods and feeling better about their general health. Both participants and their healthcare providers reported high satisfaction with the program, suggesting it was practical and acceptable to use in regular clinics.
Beyond the main findings, the study showed improvements in dietary behaviors, meaning people were making better food choices. Participants also reported improvements in their perceived general health and quality of life. The high satisfaction rates from both patients and healthcare providers suggest the program was easy to implement in Belgian primary care settings and didn’t create major burdens on the healthcare system. These secondary findings support the idea that the program works well not just for medical outcomes, but also for how people feel and function in daily life.
This study adapted a program that was already successful in the Netherlands, so researchers expected it to work in Belgium. The results align with previous research showing that lifestyle interventions combining education, group support, and individual counseling can help people with type 2 diabetes improve their health. The medication reduction rates (43% needing less medication) are particularly noteworthy and compare favorably to other lifestyle intervention studies. The weight loss of 3.6 kilograms is consistent with what other similar programs have achieved. This study adds to growing evidence that these programs can be transferred between European countries with good results.
The study had several important limitations. First, it was small with only 43 participants, so the results may not apply to all people with type 2 diabetes in Belgium. Second, there was no control group—researchers didn’t compare the program to people who received standard care without the program. This makes it harder to know how much of the improvement was due to the program versus other factors like seasonal changes or natural disease progression. Third, the study only included people in Wallonia, so results may differ in other parts of Belgium or Europe. Fourth, some people dropped out (6 out of 43 didn’t complete the program), which could affect the results. Finally, the improvement in blood sugar control was smaller at 12 months than at 6 months, suggesting the benefits may fade over time without ongoing support.
The Bottom Line
Based on this research, the Care4Diabetes program appears to be a promising approach for helping people with type 2 diabetes in primary care settings. The evidence suggests it can help reduce medication needs and improve blood sugar control, though larger studies are needed to confirm these benefits. Healthcare providers in Belgium may consider offering this program to patients with type 2 diabetes, particularly those interested in lifestyle changes. However, this should always be done under medical supervision, as medication changes require careful monitoring by a doctor.
This research is most relevant to people with type 2 diabetes who want to try lifestyle changes to improve their health and potentially reduce medications. It’s also important for primary care doctors and nurses in Belgium and other European countries looking for evidence-based programs to offer their patients. Healthcare administrators and policymakers should care about this research because it shows a program that might reduce healthcare costs and medication burden. People with type 1 diabetes or those with very advanced type 2 diabetes requiring intensive insulin therapy may not benefit as much from this program.
Based on this study, you can expect to see meaningful changes within 6 months of starting the program. Blood sugar improvements appeared at the 6-month mark, and weight loss continued through 12 months. However, the study suggests that maintaining benefits beyond 12 months may require ongoing support or refresher sessions. Most people should expect to see noticeable improvements in how they feel within the first few months, with more significant metabolic changes appearing by month 6.
Frequently Asked Questions
Can a lifestyle program help me reduce my diabetes medications?
Research shows it’s possible. In a 2026 Belgian study, 43% of people with type 2 diabetes reduced their medication needs after completing a structured 12-month lifestyle program combining group education and individual counseling. However, medication changes must always be supervised by your doctor.
How much weight can I expect to lose with a diabetes lifestyle program?
The Care4Diabetes program resulted in an average weight loss of 3.6 kilograms over 12 months in a 2026 study of 43 Belgian participants. Weight loss typically continued throughout the year, with most improvements visible by the 6-month mark.
How long does it take to see improvements in blood sugar control?
A 2026 Belgian study found significant blood sugar improvements within 6 months of starting the Care4Diabetes program, with HbA1c decreasing by 0.49%. Benefits were maintained at 12 months, though the rate of improvement slowed after month 6.
Is this diabetes program available in my country?
The Care4Diabetes program was adapted from a successful Dutch program and tested in Belgium. The European Care4Diabetes Joint Action aimed to transfer this program to 12 European countries, so it may be available in your region. Check with your primary care doctor or local diabetes organizations.
What topics are covered in the Care4Diabetes program?
The program includes five thematic group sessions (topics not fully specified in the study) plus individual check-ups with healthcare providers. Participants reported improvements in dietary behaviors and overall health, suggesting the program covers nutrition, physical activity, and lifestyle management.
Want to Apply This Research?
- Track your HbA1c test results every 3 months and record your diabetes medication doses. Also log your weight weekly and take photos of your meals to monitor dietary improvements. This creates a clear picture of whether the program is working for you personally.
- Use the app to set reminders for the five key topics covered in the program: healthy eating, physical activity, stress management, sleep, and medication adherence. Create a meal plan based on the dietary guidance from the program and log your meals to stay accountable. Set a weight loss goal of 3-5 kilograms over 6 months as a realistic target based on this research.
- Create a dashboard showing your HbA1c trend, medication changes, weight loss progress, and dietary improvements over 12 months. Set monthly check-in reminders to review progress and adjust goals. After completing the initial 12-month program, use the app to track maintenance—attending refresher sessions and monitoring whether benefits are sustained or if additional support is needed.
This research describes a clinical study of a diabetes lifestyle program in Belgium. The findings are promising but based on a small study of 43 participants without a control group. Before making any changes to your diabetes medications or treatment plan, consult with your healthcare provider. This article is for informational purposes only and should not replace professional medical advice. Individual results may vary, and the program’s effectiveness may differ based on your specific health situation, medications, and commitment to lifestyle changes.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.