Type 2 diabetes can be put into remission, suggests study

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Type 2 diabetes can be put into remission, suggests study

 

A landmark trial funded by Diabetes UK suggests it is possible to put Type 2 diabetesinto remission using an intensive low calorie diet-based weight management programme delivered entirely in primary care. 

The first year findings of DiRECT (Diabetes Remission Clinical Trial) show almost half (45.6%) of those who took part in the programme were in remission after 12 months. Remission was defined as having blood glucose levels (HbA1c) of less than 6.5% (48mmol/mol) at 12 months, with at least two months without any Type 2 diabetesmedications. 

Of the 298 people recruited to take part in DiRECT, half received standard diabetescare from their GP, whilst the other half received a structured weight management programme within primary care. The programme included a low calorie, nutrient-complete diet for 3-5 months, food reintroduction and long-term support to maintain weight loss.  

Type 2 diabetes remission was found to be closely related to weight loss. Almost 9 out of 10 people (86%) who lost 15kg or more put their Type 2 diabetes into remission. Over half (57%) of those who lost 10 to 15kg achieved remission, along with a third (34%) of those who lost five to 10kg. Only 4% of the control group achieved remission. 

The findings are published in The Lancet and were presented at the International Diabetes Federation Congress in Abu Dhabi earlier this week by the lead researchers, Professor Mike Lean from the University of Glasgow and Professor Roy Taylor from Newcastle University. 

DiRECT is a two-year trial which aims to find an effective and accessible way to put Type 2 diabetes into remission for the long term. The trial is delivered through GP practices across Scotland and Tyneside to find out if the benefits of a structured weight management programme can be felt in a real-life primary care setting. DiRECT also aims to understand why significant weight loss results in remission, to understand which groups might benefit in the future. 

Professor Roy Taylor from Newcastle University, lead researcher of the DiRECT trial, said: “These findings are very exciting. They could revolutionise the way Type 2 diabetes is treated. This builds on the work into the underlying cause of the condition, so that we can target management effectively.

“Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function. What we’re seeing from DiRECT is that losing weight isn’t just linked to better management of Type 2 diabetes: significant weight loss could actually result in lasting remission.”

Professor Mike Lean from the University of Glasgow, lead researcher of the DiRECT trial, 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.”

“We’ve found that people were really interested in this approach – almost a third of those who were asked to take part in the study agreed. This is much higher than usual acceptance rates for diabetes clinical trials. ” 

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said: “These first year findings of DiRECT demonstrate the potential to transform the lives of millions of people. We’re very encouraged by these initial results, and the building of robust evidence that remission could be achievable for some people. 

“The trial is ongoing, so that we can understand the long-term effects of an approach like this. It’s very important that anyone living with Type 2 diabetes considering losing weight in this way seeks support and advice from a healthcare professional.”

 

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