Welcome to GEM

A paradigm shift in the treatment of type 2 diabetes

Conventional treatment of type 2 diabetes starts off with a lifestyle program that focuses on restricting calories for weight loss and exercise to reduce insulin resistance. If that is not sufficient, then medications are added.

While weight loss is an effective treatment, since some people with type 2 diabetes do not need to lose weight, some do not want to lose weight and others are unsuccessful at either losing weight or keeping it off for their lifetime, an alternative lifestyle program is needed.

Introduction to GEM

GEM Choices

GEM (Glycemic load, Exercise, Monitoring BG) strives to be a safe, simple, sustainable, successful, and satisfying.

We are investigating an alternative approach, that focuses on preventing blood glucose (BG) from rising a lot after meals, and “burning” BG through reducing long bouts of sedentary behavior and incorporating moderate physical activity into one’s daily routine (IRB # 19313).  This approach is called GEM, which stands for;

G = Glycemic load of foods.  Foods with high glycemic loads, like potatoes, pasta and rice, push your BG up a lot.  These are replaced with low glycemic load foods, like fresh vegetables, beans, nuts, fruits, fish, meat, and dairy products.

E = Exercise.  The target here is breaking up long periods of sitting (like sitting at a desk, in a vehicle etc.), with brief periods of motion.  Additionally participants do 30 minutes a day of moderate activity, which could be as simple as parking a brisk 15 minute walk away from work each day and two brisk walks on the weekend.  Actually this activity could be almost anything, like water aerobics, mowing the grass with a push mower, etc.

M = Monitoring BG systematically, before and after meals and physical activities.  Systematic monitoring of BG can

  1. Educate you in terms of what foods raise your BG a lot or a little and what physical activities lower your BG a little or a lot
  2. Activate you when your BG is high to become physically active to lower your BG or eat something to raise low BG
  3. Motivate you to avoid those foods that you found spike your BG and increase those activities that lower your BG.

The guiding philosophy of GEM is that it is:

  • Simple
  • Safe
  • Satisfying
  • Successful
  • Sustainable

Introduction to Study, IRB # 19313

We are now recruiting participants to help us evaluate the benefits of GEM.

People who volunteer to participate will come to U.Va.’s Center For  Behavioral Medicine Research and will:

  • Be thoroughly informed about what is involved in participating in the study and then sign an informed consent. This form details what is involved in the study for both the researcher and the participant.
  • Receive a brief physical
  • Have blood drawn to measure your cholesterol, insulin, and BG control
  • Complete some questionnaires about your diabetes

All participants will continue with their own doctor who will adjust medications as appropriate.  Participants will be randomly assigned to a treatment group.  Random assignment means neither you nor the researcher can choose what group to participate in.

Whether you are randomly assigned to participate in GEM or not, you will be making a significant contribution to the understanding how best to treat type 2 diabetes.  Additionally, you will receive:

  • A free FitBit Charge 2
  • A free Bayer Contour Next BG meter and supplies
  • Free brief study-related physical exams
  • Free study-related blood tests that you can share with your physician
  • Payment for your time and effort


If you want further information about participating in this research, either call 434-243-6520 or e-mail t2dm@virginia.edu

Fax: 434-244-4496

GEM Contact Request

If you want us to contact you or send you a copy of the consent form to read, we would be glad to do this. If so, please provide your:

Further Information


We are a multidisciplinary team of

  • Endocrinology, Anthony McCall
  • Exercise physiology, Jeanette Garcia
  • Nurse diabetes educators, Anne Diamond
  • Nutrition, Joyce Green-Pastors
  • Optometry, Thomas Banton
  • Psychology, Daniel Cox