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+{
+  "titles": [
+    "2017 - diabetes-mellitus-in-developing-countries-and-underserved-commun-2017.pdf",
+    "2018 - Global aetiology and epidemiology of type 2 diabetes mellitus and its complications.pdf",
+    "2014 - Pathophysiology and treatment of type 2 diabetes.pdf",
+    "2011 - Lifestyle and Genetics in Obesity and type 2 Diabetes.pdf",
+    "2010 - Interactions of Dietary Whole-Grain Intake.pdf",
+    "2008 - Public Health Genomics Approach to Type 2 Diabetes.pdf",
+    "2009 - Zinc and Diabetes - clinical links and molecular mechanisms.pdf",
+    "2011 - Type 2 diabetes across generations from pathophysiology to prevention and management.pdf",
+    "2007 - Physical activity modifies the effect of SNPs in the SLC2A2 (GLUT2).pdf",
+    "2011 - Lifestyle and Genetics in Obesity and type 2 Diabetes.pdf"
+  ],
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+  "contexts": [
+    "of Type 2 Diabetes   The lifestyle intervention using physical exercise  and modi  cation of nutrition is ef  cient in pre- venting type 2 diabetes in patients with impaired glucose tolerance [  99 ]. Clinical trials con  rm  that lifestyle interventions (dietary modi  cation  and increased physical activity) reduce the risk of progressing from impaired glucose tolerance to type 2 diabetes [  105 ]. Assessing T2D risk accord- ing to FINDRISK scale [ 106 ] is quite common in",
+    "Major clinical trials have demonstrated that diet and lifestyle modifications are  effective in preventing T2DM in high-risk individuals.  T2DM management strategies including lifestyle modifications, social support and  ensuring medication adherence are key to reducing the incidence of diabetes  mellitus complications. REVIEWS NATURE REVIEWS | ENDOCRINOLOGY  VOLUME 14 | FEBRUARY 2018 | 89",
+    "focused on people with impaired glucose tolerance or impaired fasting glucose because of their high risk of development of type 2 diabetes. Several studies have examined the ability of lifestyle modi  cation and drugs to slow progression to diabetes (table 2). Findings from these trials have nearly all shown a bene  t, with lifestyle modi  cations being more e   cacious than any drug, with  the exception of the thiazolidinedione anti diabetics. 163175",
+    "no or just minor weight loss was achieved, diabetes incidence was also reduced (   Pan et al., 1997   ;    Ramachandran et al., 2006   ). In addition, on the long term weight was partially or totally regained in all of the studies (   Knowler et al., 2009   ;    Li et al., 2008   ;    Lindstrom et al., 2006   ;    Lindstrom et al., 2003   ). Despite this regain T2DM risk remained low or decreased further, thus the e  ect of lifestyle is unlikely to be solely due to",
+    "proven particularly effective for preven-tion and management of type 2 diabetes.For example, improvement in dietaryquality, in conjunction with other lifestylemodications like increased physical ac-tivity, was shown to be more effectivethan pharmacological treatment in pre-vention of diabetes in individuals at highrisk (1). Further, lifestyle modicationmay mitigate the risk associated with thestrongest known diabetes risk loci (2).While the existence of environmental in-uences on genetic risk (and vice",
+    "spite of our incomplete knowledge of the genetics of type 2diabetes today, the burden of type 2 diabetes can be amelio-rated at the population level. Recent studies have found thatlifestyle changes through diet and exercise can prevent or",
+    "Lifestyle modification including exercise, nutrition and behavioral changes is the cornerstone to prevent and treat type 2 diabetes. Oral antidiabetic medication either as single agent or combination therapy is frequently required to maintain metabolic control, as assessed by monitoring ofglycated hemoglobin A 1C(HbA 1C) levels. Eventually, asignificant proportion of patients with type 2 diabetes require the exogenous administration of insulin [40].",
+    "diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 134350. 114 Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in  the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393403. 115 Ramachandran A, Snehalatha C, Mary S, Mukesh B, Bhaskar AD,",
+    "type 2 diabetes. Physical activity, favorable dietary changes,and weight reduction were essential components of a success-ful lifestyle intervention in two large randomized controlled trials on the prevention of type 2 diabetes in high-risk individ-uals with impaired glucose tolerance (IGT), including theFinnish Diabetes Prevention Study (DPS) (44) and the Diabe-tes Prevention Program (DPP) (22). In the DPS, increasedphysical activity was associated with a decreased risk of type",
+    "demonstrate that lifestyle modi  cation comprising higher levels  of PA and prudent food consumption may be e  ective in obesity  and T2DM prevention. The positive e  ect of lifestyle on body  weight seems somewhat transient, whereas the e  ect on T2DM  is sustained for longer periods. Furthermore, lifestyle modi  ca- tion appears to have an e  ect on diabetes risk independently of  body weight and even of weight loss.      Lifestyle and Genetics in Obesity and Type 2 Diabetes"
+  ],
+  "answer": "Lifestyle changes, particularly those involving diet and physical activity, have been shown to be effective in managing and even reversing type 2 diabetes (T2DM). Several sources in the provided context support this:  1. **Prevention and Management**: Lifestyle interventions, including dietary modifications and increased physical activity, have been proven effective in preventing the progression from impaired glucose tolerance to type 2 diabetes [1], [2], [3], [5], [9]. These interventions are more efficacious than pharmacological treatments in some cases [5].  2. **Sustained Effects**: The positive effects of lifestyle changes on type 2 diabetes risk are sustained over longer periods, even if weight is partially or totally regained [4], [10]. This suggests that the benefits of lifestyle modifications are not solely dependent on weight loss.  3. **Cornerstone of Treatment**: Lifestyle modification, including exercise, nutrition, and behavioral changes, is considered the cornerstone for both preventing and treating type 2 diabetes [7].  In summary, lifestyle changes can indeed play a significant role in reversing type 2 diabetes, as evidenced by multiple clinical trials and studies [1], [2], [3], [4], [5], [7], [9], [10].",
+  "question": "Can lifestyle changes reverse type 2 diabetes?"
+}
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