Diabetes Remission And How To Achieve It


Diabetes Remission And How To Achieve It

Professor Mike Lean describes diabetes remission and how to achieve it

In this interview, Professor Lean begins by explaining what is meant by diabetes remission. He then briefly describes the ‘DiRECT’ diabetes remission trial that was run in Scotland and northern England by teams led by Prof Lean in Glasgow and Prof Roy Taylor in Newcastle. In the DiRECT trial, he showed how people, with a diagnosis of diabetes within the last six years, had a high chance of remission if they lost enough weight (10-15kg). He described how this was achieved using a specially formulated total diet replacement (TDR) program with support from health care professionals (dietitians and practice nurses) followed by a step-wise reintroduction of conventional food and a well-managed weight maintenance program afterward. Maintaining weight loss has proved challenging and some ways in which people can help themselves to maintain a new lower body weight were considered.
The evidence from several trials undertaken in the UK, in the Middle East and in Glasgow on people from South Asia provides a solid foundation for changing type 2 diabetes management. Prof Lean believes that the time is right to introduce weight loss as the first step in the management of type 2 diabetes not just in those who are overweight and obese, but also for those who may be within the ‘normal’ weight range but in whom, as shown in a study from Roy Taylor in Newcastle, weight loss reduces their excessive liver and pancreatic fat thereby improving their metabolic state, and leading to remission of diabetes in some participants.
Recently published guidelines on diet for type 2 diabetes in Europe emphasize the need for weight loss and state that the most effective way to achieve the needed 10-15kg weight loss is to use a formula total diet replacement (soups and shakes 800kcal/d diet) but Prof Lean points out that achieving that weight loss by any means can be effective too. This may also be by increased use of traditional foods but weight losses with reducing diets based on conventional traditional foods tend to be not as good as with total diet replacement.
Viewers and readers who are concerned about their family history of diabetes and their rising body weight can check their risk online by using risk calculators (see links below). Those at high or intermediate risk are advised to consult a doctor to ask for a blood test and discuss their concerns.
Web links to useful sources of information are given below.
About Diabetes:
Diabetes remission:

Long-term (5 years) results of Diabetes remission trial:

Diabetes prevention:
The Canadian Diabetes Risk Calculator:
The Indian Diabetes Risk Score: 
UK Type 2 diabetes – know your risk

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