Resources  |  Effects and feasibility of a prehabilitation programme with type 2 diabetes

Effects and feasibility of a prehabilitation programme with type 2 diabetes

 R. Laza-Cagigas   S. Chan   D. Sumner   T. Rampal  

We performed a retrospective study of diabetic patients undergoing a targeted multimodal prehabilitation programme to assess changes in their diabetic control and functional capacity prior to surgery. As part of the programme, patients were encouraged to follow a low-carbohydrate, high-fat (LCHF) dietary approach. We aimed to assess the feasibility and effects of this programme on our cohort of patients.

Highlights of study

• It is feasible to incorporate a low-carbohydrate, high-fat dietary approach within the context of surgical rehabilitation.

• Multimodal prehabilitation can improve diabetic control in surgical patients with Type 2 diabetes (T2D).

• Prehabilitation is a teachable moment and may result in positive behavioural modifications and long-standing health benefits.


From 79 patients attending prehabilitation, 17 (13 males, age (median [interquartile range]): 71 [63–79] years) had Type 2 diabetes and none had Type 1. Patients had undergone a targeted multimodal prehabilitation programme prior to surgery, which comprised supervised exercise sessions (aerobic or resistance training), nutritional education

(LCHF suggestion, correct protein intake, and avoidance of processed food), psychological support and medical optimization. Weight, body mass index (BMI), glycosylated haemoglobin (HbA1c), fasting glucose, and functional capacity were measured prior to and after prehabilitation. Data were compared with a Wilcoxon signed-rank test.


There were significant improvements in HbA1c (P = 0.000), fasting glucose (P = 0.006), weight (P = 0.002), and BMI (P = 0.002). There were no significant improvements in functional capacity.


We have shown that in the preoperative period, a targeted multimodal prehabilitation programme incorporating a LCHF diet improves diabetes control in patients with T2D awaiting elective surgery. Our approach is novel as a LCHF diet has not previously been utilized in patients with diabetes within this context. Prospective studies are required in the context of post-operative outcomes.


Some of the data gathered in this paper were previously presented as an abstract under the title Diabetes in the Surgical patient-place for Prehab intervention? at the Prehabilitation World Congress in London on the 2nd and July 3, 2019.

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