Diabetes remission in the middle East and among North Africans

Long version for Bittertruth for release on 9th May 2025
Health chat with Dr Anthony Leeds Series 5 part 2 episode 1
Title: Diabetes remission in the middle East and among North Africans
Interview with Professor Shahrad Taheri, University of Leicester, United Kingdom
In this interview Professor Taheri describes the ‘DIADEM-1’ study in which an intensive life-style intervention delivered diabetes remission (one year after starting the weight reduction programme) in 61% of people with early type 2 diabetes from the Middle East and North Africa in a study undertaken in Qatar. The effects of using a short-term total diet replacement 810kcal/d diet followed by gradual food reintroduction and a strong weight maintenance program including lifestyle and exercise guidance gave results similar to those from the ‘DiRECT’ diabetes remission trial (see below)
The importance of the ‘DIADEM-1’ study described here by Prof Taheri is that it confirmed that a similar weight loss intervention could be offered to people of Middle Eastern and North African origins, was acceptable and successfully delivered a slightly greater proportion of people with remission of diabetes than the DiRECT trial. Subsequent studies have shown that ethnicity is not a barrier to effective weight loss with total diet replacement programmes but subsequent weight maintenance programmes need to be culturally appropriate to be effective.
The conversation moved on to consider another recent study by Prof Taheri with colleagues including Professors Lean and Taylor (see below) in which thousands of protein markers in tiny blood samples from the participants of the DiRECT and DIADEM-1 study were measured by a novel technique to observe effects of weight loss. Proteins linked to cardiovascular function and separate markers of liver function and fatty liver changed in response to weight loss, more so after weight losses greater than 10kg in samples taken up to one year from starting the diet. The greater benefits shown by protein markers after greater weight losses showed the importance of maintaining the greater dietary energy restriction after the initial weight loss to achieve maintained diabetes remission, reduced fat in the liver and improved cardiovascular risk markers.
The conversation concluded, noting the intention to discuss fatty liver disease in the next episode.
In Series 4 Episode 2 released on June 14th 2024 Update on Diabetes remission. Prof Lean described how, with sufficient weight loss, people with a recent diagnosis of diabetes 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 gradual reintroduction of conventional food and a well-managed weight maintenance program afterwards. This amount of weight lost was also linked to a reduction in blood pressure, reduced use of blood pressure medicines and improved quality of life. The ‘DiRECT’ trial was a study on participants who were largely white British and he emphasized the need for studies in other population groups to confirm the effects. A ‘soups and shakes’ total diet replacement programme has already been rolled out across Scotland and England by the UK’s NHS and preliminary results have been published.

Web-links to useful sources of information are given below. Those concerned about their risk of developing diabetes can use the on-line risk calculators given below, and if appropriate should consult a doctor or health care professional where possible.

Anthony R Leeds

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Below are important links;

About Diabetes:

Diabetes remission in the UK:

Treating your Diabetes

Research Spotlight

Long term (5 year) results of UK Diabetes remission trial:

Series 4 Episode 2:
June 14^th 2024 Update on Diabetes remission – Prof Mike Lean, University of Glasgow

Diabetes remission in the Middle East and North Africa:

Studies of multiple protein markers (proteomics) in the DiRECT and DIADEM studies:

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