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GPN-led weight loss programme leads to sustained diabetes remission

Primary care-based weight loss programmes may lead to sustained remission for patients with type 2 diabetes, a study has found.

More than a third of patients who took part in a weight loss programme delivered at their GP surgery are in remission from type 2 diabetes two years later.

At two years’ follow up, 36% of patients on the weight loss programme were in remission from type 2 diabetes, compared to just 3% in the control group. Those on the intervention also had significant reductions in HbA1c and blood pressure levels compared to the controls.

The researchers noted that 70% of patients who maintained a weight loss of over 15kg were in remission at two years and that those who reverted to diabetes regained more weight during the follow up period than those who achieved remission.

The Diabetes UK-funded DiRECT study, carried out by researchers at the universities of Newcastle and Glasgow, looked at just under 300 patients from UK general practices with type 2 diabetes.

Half of the patients were assigned to a weight loss programme, delivered by a practice nurse or dietitian, which included 3-5 months of a calorie-controlled total diet replacement drink, 6-8 weeks of food reintroduction and then monthly appointments with the nurse or dietitian for two years. They also had their diabetes and antihypertensive medications stopped during the intervention.

The other half of the patients received usual care from their GP surgery.

They said in the paper: ‘The two-year results… confirm that type 2 diabetes is potentially reversible by weight loss in many cases. A structured primary care-based weight management programme within six years of diagnosis can sustain remission to a non-diabetic state, off antidiabetes drugs, for more than a third of people with type 2 diabetes, with sustained remission linked to the extent of sustained weight loss.’

These findings come after NHS England announced in November that they would be launching a pilot that would see up to 5,000 diabetes patients trialling a calorie-controlled liquid diet to see if it helped them to achieve remission.

NHS England’s announcement followed the publishing of results from the first year of follow up in the DiRECT study, which found that almost half of patients were able to achieve remission on the weight loss programme.