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Selection bias: The researchers only used subjects with type 2 diabetes diagnosed for less than 10 years. Patients diagnosed with type 2 diabetes for more than 10 years were excluded from the study.

Attrition: 2 patients from the intervention/lifestyle group were lost to follow-up at 3 months; from the standard care group, 2 patients were lost to follow-up at 3 months and another 1 patient was lost to follow-up at 9 months.

Performance bias: Blinding was done to all the test personnel, a factor that reduced the possibility of performance bias.

Participants were recruited via media and the Danish Diabetes Association and screened through telephone interview and medical examination.

Inclusion criteria: Type 2 diabetes diagnosed less than 10 years, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of 25 to 40, and taking 2 or fewer glucose-lowering medications.

Exclusion criteria: HbA1c level greater than 9%, insulin-dependence, or presence of 1 or more of the following complications: diabetic retinopathy, macroalbuminuria (urine albumin-creatinine ratio ≥300 mg/g) or nephropathy (plasma creatinine ≥1.47 mg/dL [to convert to μmol/L, multiply by 88.4]).

All participants were exposed to standard care with individual counseling and standardized, blinded, target-driven medical therapy. Additionally, the lifestyle group was subjected to 5 to 6 weekly aerobic training sessions (duration 30-60 minutes), of which 2 to 3 sessions were combined with resistance training. The lifestyle participants also received dietary plans aiming for a body mass index of 25 or less. Participants were followed up for 12 months.

Secondary outcome: Reduction in glucose-lowering medication from baseline to 12-month follow-up.

Exploratory outcomes: Changes from baseline to 12-month follow-up in total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressure, fasting insulin, fasting glucose, 2-hour glucose concentration following an oral glucose tolerance test, maximal oxygen uptake (V˙ O2max), weight, BMI, fat mass (total and abdominal), and lean body mass.

From baseline to 12-month follow-up, the mean HbA1c level changed from 6.65% to 6.34% in the lifestyle group and from 6.74% to 6.66% in the standard care group not meeting the criteria for equivalence (P = .15).

Reduction in glucose-lowering medications occurred in 47 participants (73.5%) in the lifestyle group and 9 participants (26.4%) in the standard care group.