A new programme involving an intensive diet of 800 calories a day could help put Type 2 diabetes into remission, suggests the biggest research study we’ve ever funded.
DiRECT (short for Diabetes Remission Clinical Trial) has been testing a new approach to putting Type 2 diabetes into remission in just over 300 people with Type 2 diabetes.
Scientists leading the trial, Professors Mike Lean and Roy Taylor (Roy pictured above), have just announced the initial results at the International Diabetes Federation Congress in Abu Dhabi, also published in the Lancet. The results shows that a new weight management programme resulted in almost half the participants (45.6%) being in remission of Type 2 diabetes after 12 months.
The programme involves a low-calorie, nutrient-complete, liquid diet for 3 to 5 months. Food is then reintroduced and those taking part are provided with long-term support to maintain their weight loss. It’s delivered entirely through GP practices, with nurses and dietitians.
The study found there was a close link between remission and total weight loss. 86% of people who lost more than 15kg on the programme put their Type 2 diabetes into remission after a year. As did 57% of those who lost 10 to 15kg, along with 34% of those who lost 5 to 10 kg. In the comparison group, where people with Type 2 diabetes received standard care, only 4% achieved remission.
Professor Mike Lean from the University of Glasgow, a lead researcher of the study, said this could benefit not only people with Type 2 diabetes, but the NHS too:
“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.”
What’s Type 2 diabetes remission? Remission doesn’t mean that Type 2 diabetes is gone for good. It means that blood glucose levels have returned to a healthy range again. In this trial, the team defined remission as having blood glucose levels (HbA1c) below 6.5% (48mmol/mol) after 12 months, with at least two months without any Type 2 diabetes medications.
Isobel Murray, from Scotland, took part in DiRECT for two years and put her Type 2 diabetes into remission:
“I’m absolutely over the moon that I‘ve been able to put my diabetes into remission.
Following the diet for 17 weeks was one of the most challenging things I have ever done, but it’s changed my life. I now live a healthy and active life to ensure that I stay in remission.”
We still don’t know if putting Type 2 diabetes into remission can protect against diabetes-related complications later in life. That’s why it’s important that people in remission get regular healthcare checks, so any complications can be monitored and signs of Type 2 diabetes coming back can be caught early.
DiRECT isn’t finished yet, and more research will help us understand the biology behind the programme, shedding light on the effects of a low-calorie diet inside the body.
We also need to find out who could benefit most from treatments like this in the future, taking into account factors like weight, ethnicity or how long someone has lived with Type 2 diabetes.
We’ve committed a further £300,000 to DiRECT, so some people can be followed for another three years and the cost-effectiveness of the programme can be evaluated. This will help us understand the longer-term benefits, to see if a treatment like this could be offered to people with Type 2 diabetes in the future.
Dr Elizabeth Robertson, our Director of Research, said these latest results are hugely promising but it’s just the beginning:
“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 gets support and advice from a healthcare professional.”
Read on to find out more about how our DiRECT low-calorie research came to life – where you can hear from our scientists and the people with Type 2 diabetes who took part in the study.