Recent findings from a three-year observational extension of the groundbreaking Diabetes Remission Clinical Trial (DiRECT) suggest that individuals in remission from type 2 diabetes at the conclusion of the original study’s second year maintained remission at a notable rate of 26% by the fifth year. The overall remission rate stood at 13% among participants with available data at the five-year mark.
The study’s five-year results represent a significant advancement, revealing a substantial reduction in the occurrence of serious medical events requiring hospitalization among those who underwent the diet intervention. Moreover, participants who sustained lower weight and remained in remission from type 2 diabetes experienced fewer diabetes-related complications over time.
Published in The Lancet Diabetes & Endocrinology, these crucial findings underscore the efficacy of weight management and dietary interventions in controlling and achieving remission from type 2 diabetes. The research highlights the urgent need for increased clinical investment in diet-based therapies for managing this disease, with a particular emphasis on assisting individuals in maintaining long-term weight loss and reaping associated health benefits.
Conducted by researchers at the Universities of Glasgow and Newcastle and funded by Diabetes UK, the DiRECT trial yielded promising outcomes by lowering blood pressure, reducing the reliance on anti-hypertensive medications, and facilitating remissions of type 2 diabetes. The trial involved a 12-week, 830-calorie formula diet aimed at inducing weight loss, followed by guidance to gradually reintegrate healthy meals from ordinary foods and sustain weight loss.
The DiRECT-Extension study, designed to assess the sustainability of weight loss and remissions achieved during the original trial, provided low-intensity weight-loss maintenance support to 95 participants who remained from the initial DiRECT cohort. Over the ensuing three years, participants received periodic appointments at their GP surgeries, or remotely during COVID-19 lockdowns, for monitoring of weight, blood sugar levels, and blood pressure, along with guidance to uphold weight loss.
The results of the DiRECT-Extension study underscore the enduring effectiveness of prolonged weight management in controlling and achieving remission from type 2 diabetes. However, notable weight regain was observed in some participants, particularly up to the third year, highlighting the challenges associated with sustaining weight loss and the necessity for innovative approaches to support patients in this endeavor. Nevertheless, individuals who maintained remission achieved an average weight loss of 8.9kg by the fifth year.
Overall, participants in the DiRECT-Extension group exhibited an average weight loss of 6.1kg at the five-year mark. Notably, those in the original DiRECT intervention group, who received routine diabetes care alongside weight loss guidance, experienced fewer diabetes-related complications and a higher rate of remission compared to the control group.
Professor Mike Lean, co-designer of the original DiRECT trial and senior author of the DiRECT-Extension study, emphasized the transformative potential of weight management in reversing type 2 diabetes and reducing diabetes-related complications. He stressed the importance of sustained research funding to enhance outcomes and prevent weight regain, urging a shift in treatment focus from mere glycemic control to effective weight management.
Professor Roy Taylor, co-designer of the original DiRECT trial and senior author of the DiRECT-Extension study, echoed these sentiments, highlighting the feasibility of long-term remission through sustained weight loss.
Dr. Elizabeth Robertson, Director of Research at Diabetes UK, underscored the organization’s commitment to funding research aimed at facilitating type 2 diabetes remission and supporting individuals in maintaining remission for prolonged periods.
The study, titled “Five-year follow-up of the randomized Diabetes Remission Clinical Trial (DiRECT): Extension study of continued support for weight loss maintenance,” is published in The Lancet Diabetes & Endocrinology and was funded by Diabetes UK.