Losing weight can put type 2 diabetes in remission ‘for at least five years’

Losing weight can put type 2 diabetes in remission for at least five years, new data has suggested.

Figures from the Diabetes Remission Clinical Trial (DiRECT) show that around a quarter of people in remission from diabetes two years after starting a low-calorie diet were still in remission three years later.

These people no longer needed to take medication to manage their blood sugar levels and had an average weight loss of around 1st 6lb (8.9kg) at the five-year point.

The data suggests that losing weight and keeping it off can help reverse diabetes, a serious condition that increases the risk of heart disease, stroke, high blood pressure, narrowing of blood vessels and nerve damage.

Obesity is a major driver of type 2 diabetes, with research suggesting that obese people are up to 80 times more likely to develop the condition than those with a healthy body mass index (BMI) of less than 22.

Of the 298 people who took part in the original DiRECT study, half received standard diabetes care from their GP and half were put on a diet with support from health professionals.

This included a low-calorie, nutrient-complete soup and shake diet (around 800 calories per day) for between 12 and 20 weeks, together with support from a nurse or dietician to reintroduce healthy foods and maintain weight loss.

Medications for type 2 diabetes and blood pressure were stopped at the beginning of the programme and reintroduced as necessary.

At the end of the original two-year study, 95 of the 149 people on the weight-loss programme agreed to take part in an extension study lasting three years.

This new data shows that, of this group of 95 people, 48 were in remission at the start of the extension study, and 23% of these were still in remission three years later.

The proportion of people in remission five years after the original study started was more than three times that of the DiRECT control group, who just received usual GP care.

Remission was closely linked to weight loss and keeping the pounds off. Researchers said those people who came out of remission had regained the weight they had lost.

Anyone who regained more than just over 4lb (2kg) during years three to five of the study were offered an additional package of support, available once a year, consisting of the low-calorie soups and shake diet for four weeks, followed by help while reintroducing normal meals.

Compared to the control group, those put on a diet and offered support had bigger improvements in blood pressure and blood sugar levels and fewer people needed medication.

The number of serious health issues resulting in hospital admission in the dieting group was also less than half that in the control group.

Diabetes UK, which funded the study, said the findings support growing evidence that weight loss and remission from type 2 diabetes can prevent or delay the complications of diabetes.

Professor Mike Lean, at the University of Glasgow, who co-led the study, said: “Type 2 diabetes causes a range of progressive and life-shortening complications, notably blindness, infections, amputations, kidney failure and heart failure.

“It affects over four million people in UK and accounts for about 10% of NHS funding.

“The DiRECT extension (study) has shown us that a substantial proportion of people, managed in primary care, can maintain sufficient weight loss to be free from the condition for up to five years.”

Professor Roy Taylor at Newcastle University, who also led the study, said: “The DiRECT five-year follow-up shows that the rapid weight-loss programme brings about considerable weight loss at five years with low-intensity support.

“The most important question now is how the follow-up programme can be even more successful at an affordable cost.”

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