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Journal of
Diabetes Nursing


Early View

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“Soups and shakes” diet programme expands

A low-calorie treatment programme for type 2 diabetes is to double its capacity in England, under a new expansion plan.

Overweight man in clinic

The NHS Type 2 Diabetes Path to Remission programme is to be rolled out across the whole of England this year. The expansion to 42 local health areas will double the capacity of the programme and benefit many more people recently diagnosed with type 2 diabetes.

Inspired by the ground-breaking DiRECT study, the programme is a joint initiative between NHS England and Diabetes UK. To help kick-start weight loss, eligible participants are provided with nutritionally balanced, low-calorie meal replacement products. These soups, shakes and bars deliver 800–900 calories per day for the first 12 weeks. 

After this phase, people are carefully supported by healthcare professionals to reintroduce healthy, nutritious food into their diet to maintain weight loss, and to increase their physical activity levels. Participants can choose whether to access this help through one-to-one in-person sessions, group sessions or digitally through an app or online.

Over 20,000 people have taken part in the programme since its pilot was launched in 2020. Analysis of its outcomes show that it is effective in improving people’s diabetes control and supporting their weight loss, with participants on average losing 7.2 kg after one month and 13 kg over the 12-month programme. Clinical trials suggest that such outcomes can lead to remission of type 2 diabetes in up to half of those who reach them.

The programme’s expansion is being supported by £13 million this year. Individuals need to meet a set of criteria to be referred by their GP. These include:

  • Aged 18–65 years.
  • A diagnosis of type 2 diabetes within 6 years.
  • A BMI ≥27 kg/m2 (if from a White ethnic group) or ≥25 kg/m2 (if from Black, Asian or other ethnic minority group).
  • An HbA1c measurement of 43–87 mmol/mol in the last 12 months (if on antidiabetes drugs) or 48–87 mmol/mol (if not on antidiabetes drugs).

Similar programmes can be accessed in Scotland, and “soups and shakes” weight-loss initiatives have also been piloted in Northern Ireland and Wales. 

NHS National Clinical Director for Diabetes and Obesity, Dr Clare Hambling commented: “The rollout of this innovative programme across the NHS in England provides a holistic and compassionate way to help people living with type 2 diabetes and overweight or obesity.

“Weight loss can lead to significant health benefits, including for some, remission of type 2 diabetes, and it’s important the NHS offers a wide range of services that are easy to access and tailored to those looking to manage their condition.”

For adults who are living with obesity and also have diabetes, hypertension or both, help is available nationally through the NHS Digital Weight Management Programme. This 12-week programme can be accessed following referral from primary care or local pharmacist.

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