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Sustained weight management effective in controlling type 2 diabetes

Sustained weight management effective in controlling type 2 diabetes

Weight loss can put type 2 diabetes into remission for at least five years, new research suggests.

Scientists at the University of Newcastle showed that long-term remission from type 2 diabetes is possible if sufficient weight loss is achieved and maintained.

The five-year study found that over a quarter of the participants in remission at the end of year two remained in remission after five years.

The longer participants were able to maintain a lower weight and remission of their type 2 diabetes, the less likely they were to suffer from some diabetes-related medical complications.

The findings are published in The Lancet, Diabetes and Endocrinology and highlight the critical need for investment in weight management therapies to help manage the condition.

Type 2 diabetes is a growing problem. The Government estimates that 3.8 million people aged 16 years and over in England have diabetes (diagnosed and undiagnosed), with type 2 diabetes accounting for 90 per cent of the cases.

This new study is an extension of the Diabetes Remission Clinical Trial (DiRECT) conducted by the same research group, demonstrating for the first time that type 2 diabetes can go into remission through a dietary intervention programme in primary care settings. The original DiRECT study involved a 12-week 830-calorie formula diet to induce weight loss, followed by support to introduce healthy meals from ordinary foods and maintain weight loss.

Building on the original work, the researchers designed the DiRECT-Extension study to investigate whether participants could sustain weight loss and remission beyond the original two-year trial and if there might be wider health benefits.

From the original study participants, 95 patients continued with the new study and took part in a low-intensity weight loss maintenance programme for an additional three years. This involved regular GP appointments to review weight, blood sugar levels and blood pressure, as well as receiving advice and support to help maintain weight loss.

ndings from the extension study show that prolonged weight management is effective for the control and remission of type 2 diabetes. Participants who remained in remission showed an average weight loss of 8.9 kg at five years.

Overall, those in the DiRECT-Extension group lost an average of 6.1kg at five years. People in the original DiRECT control group receiving routine diabetes care with no additional interventions lost an average of 4.6kg.

The five-year results also suggested wider health benefits from the diet intervention, with participants who maintained weight loss having fewer diabetes-related clinical events. Overall, the remission rate after dietary interventions for five years was 13 per cent, which resulted in a halving of the number of serious medical events needing hospitalisation.

Professor Roy Taylor, from Newcastle University, who co-designed the original DiRECT trial and is a senior author of the latest DiRECT-Extension study, said: ‘This five-year study demonstrates that long-term remission from type 2 diabetes is possible if sufficient weight loss is achieved and maintained.’

He added: ‘Whether or not remission of diabetes was achieved, those people who were assigned to the weight loss group had less than half of the serious health issues experienced by the conventionally treated group. These are encouraging outcomes which should help change how this serious condition is managed.’

Professor Mike Lean, who co-designed the original DiRECT trial and is the senior author of the latest DiRECT-Extension study, said that DiRECT has made a ‘worldwide paradigm shift’ in the understanding and treatment of type 2 diabetes.

He added: ‘The five-year results now suggest that diet treatment for weight loss to achieve a period of remission is likely to be accompanied by greater freedom from some diabetes complications and fewer people being admitted to hospital with medical problems. We must now call for much more effective, long-term funding for research to improve on these results – especially to prevent weight regain.’


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