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STUDY: Rapid weight loss can lead to long-term remission for those living with type 2 diabetes

Research from the UK reveals that around a quarter of participants in a landmark trial were still in remission after five years.

  • A new study reveals that remission from type 2 diabetes can be long-term
  • The landmark trial of weight management program is the first to study remission over a five year period
  • Those taking part in the program were at reduced risk of diabetes complications

People who lost weight and put their diabetes into remission for two years, thanks to a trial funded by Diabetes UK, may have achieved long-term remission. This is according to new research led by Professor Roy Taylor at Newcastle University and Professor Mike Lean at the University of Glasgow. Their findings show that 23% of participants in the Diabetes Remission Clinical Trial (DiRECT) who were in remission after two years remained in remission at the five year mark.

Being in remission means that these participants no longer need to use diabetes medications to manage their blood sugar levels. These participants had maintained an average weight loss of 8.9kg after five years.

Carried out at Newcastle University, the original two-year DiRECT trial tested out a weight management program for people who had been diagnosed with type 2 diabetes within the past six years. The people taking part were aged between 25 and 65 and were all overweight. The trial involved 12 weeks of a low-calorie formula diet, followed by support to gradually reintroduce healthy foods while maintaining weight loss. The trial was the first to show that remission from type 2 diabetes is possible through a dietary intervention in primary care, with almost half (46%) of the 306 participants being in remission one year later, and 36% after two years.

The proportion of participants who were in remission after five years of the trial program was more than three times that of the control group, who did not take part in the original low-calorie diet program.

In the extension study, which was designed to demonstrate possible longer-term benefits of the program, 95 participants of the original study (48 of whom were in remission at the start of the extension) continued to receive support to help maintain weight loss over the next three years. They received nurse or dietitian appointments at their GP surgery every three months to review their weight, blood sugar levels and blood pressure, and were offered advice and support to maintain their weight loss.

Participants who regained more than 2kg during years 3-5 were offered an additional package of support, available once each year, consisting of the low-calorie ‘soups and shakes’ diet for four weeks, followed by support while reintroducing normal meals.

During the three-year extension, 82 participants from the original DiRECT control group – who originally received best type 2 diabetes care according to guidelines – were advised to lose weight. People in the control group did not receive the three-monthly appointments, or additional ‘soups and shakes’ packages during the extension period.

The benefits for the intervention participants were not limited to weight loss and long-term remission. Overall, the intervention group saw greater improvements in blood pressure and blood sugar levels, compared to the control group. The number of ‘serious adverse events’ (events resulting in hospital admission) in the intervention group was less than half that in the control group. These findings support growing evidence that weight loss, and remission from type 2 diabetes, can prevent or delay the complications of diabetes.

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