In the Diabetes Remission Clinical Trial (DiRECT), British researchers randomly assigned doctors who were treating roughly 300 overweight or obese people with type 2 diabetes to either follow usual treatment guidelines (control group) or to take patients off diabetes drugs and put them on a three-stage weight-loss program (intervention group) that included:
- a formula diet (shakes and soups) with 825 calories a day (for 12 to 20 weeks),
- a gradual return to foods (for 6 to 8 weeks),
- monthly counseling to keep the weight off, and
- a “rescue plan” option—going back to a formula diet if they regained more than a few pounds.
The patients, aged 20 to 65, had been diagnosed with diabetes within the previous six years, and none were taking insulin when the study began.
After two years, 36 percent of people in the intervention group—but only 3 percent of those in the control group—had blood sugar levels below the diabetes range (hemoglobin A1c below 6.5%) without taking diabetes drugs.
Weight loss was key: 64 percent of all participants who lost at least 22 pounds were in remission after two years. But 29 percent of those who lost 11 to 21 pounds and only 5 percent of those who lost less than 11 pounds were in remission after two years.
The results “pull down the curtain on the era of type 2 diabetes as an inevitably progressive disease,” said co-author Roy Taylor of Newcastle University.
(The study was funded by a charity called Diabetes UK, but several authors had ties to the company that sells the shakes and soups used in the trial.)
What to do: Got type 2 diabetes and extra weight? Try to lose it—with any diet—and then talk to your doctor about changing your meds.
The information in this post first appeared in the May 2019 issue of Nutrition Action Healthletter.
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