Diabetes reversed with weight loss alone

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Type 2 diabetes (T2D) can be reversed with an intensive weight management programme, according to findings from a randomised trial in adults with T2D for up to six years, published in The Lancet.

The Diabetes Remission Clinical Trial (DiRECT) included 298 patients from 49 practices who were randomly assigned to receive either an intervention programme or best-practice care according to guidelines (control). The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825-853kcal/day formula diet for 3-5 months), stepped food reintroduction (2-8 weeks), and structured support for long-term weight loss maintenance.

At 12 months, the authors recorded a loss of 15kg or more in 24 per cent of participants in the intervention group and no participants in the control group. Diabetes remission was achieved in 46 per cent of participants in the intervention group and 4 per cent of participants in the control group.

“Our findings suggest that the very large weight losses targeted by bariatric surgery are not essential to reverse the underlying processes which cause type 2 diabetes. The weight loss goals provided by this programme are achievable for many people,” said author Professor Roy Taylor