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Landmark trial shows type 2 diabetes remission with intensive low-calorie diet

Journal of Diabetes Nursing – Winter newsletter

Landmark trial shows type 2 diabetes remission with intensive low-calorie diet.

Nearly half (45.6%) of those who took part in a primary-care based weight management programme were in remission from type 2 diabetes after 12 months.
 
DiRECT (Diabetes Remission Clinical Trial) is a 2-year trial assessing the effectiveness of a structured weight management programme delivered through primary care across Scotland and Tyneside. Lead researchers, Professor Mike Lean from the University of Glasgow and Professor Roy Taylor from Newcastle University, presented the first year results at the International Diabetes Federation Congress in Abu Dhabi last week.
 
Fror the purposes of the study, remission was defined as having HbA1c of less than 48 mmol/mol (6.5%), with at least two months without any type 2 diabetes medications.
 
Of the 298 people with type 2 diabetes participating in the study, half received standard diabetes care from their GP, while the other half received a structured weight management programme within primary care. The programme included a low calorie for 3–5 months, food reintroduction and long-term support to maintain weight loss.
 
The link between weight loss and remission was clear. Almost 9 out of 10 people (86%) who lost 15kg or more put their type 2 diabetes into remission, as well as 57% of those who lost 10 to 15kg. Only 4% of the control group achieved remission.
 
Professor Mike Lean said: “Putting Type 2 diabetes into remission as early as possible after diagnosis could have extraordinary benefits, both for the individual and the NHS. DiRECT is telling us it could be possible for as many as half of patients to achieve this in routine primary care, and without drugs.”
 
The trial findings have been published in the Lancet: https://doi.org/10.1016/S0140-6736(17)33102-1

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