DiRECT weight loss programme puts type 2 diabetes into remission

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Over a third of participants on an NHS weight management programme who put their type 2 diabetes into remission are still free from the condition two years on, new research has confirmed. The two-year results from the Diabetes Remission Clinical Trial (DiRECT) also showed that just under 80% of participants who had achieved remission at 12 months maintained this at 24 months. The research from Newcastle University and the University of Glasgow showed how type 2 diabetes remission was closely associated with weight loss. Two-thirds of participants who lost more than 10kg, or a stone and a half, continued to be free from type 2 diabetes 24 months later. The DiRECT weight management programme involves consuming a liquid 800-calorie diet of processed soups and shakes, along with non-starchy vegetables, for three to five months, before progressively reintroducing solid foods over a further two months. People who went through the DiRECT programme enjoyed an improved quality of life and required less type 2 diabetes medication. The research backs up the one-year findings from our award-winning Low Carb Program, published last summer, which was shown to be "effective" in improving blood glucose control, weight loss and reducing diabetes medications. Many of the Low Carb Program community have lowered their HbA1c and lost weight as well as putting their type 2 diabetes into remission. In contrast to the DiRECT programme, the Low Carb Program focuses on eating real, minimally-processed foods. The latest DiRECT results were revealed on Wednesday 6 March at the Diabetes UK Professional Conference, and have also been published in The Lancet. They build on initial findings released in December 2017, which showed that 46% of participants were in remission for type 2 diabetes after 12 months, with 70% still in remission 24 months later. Remission was defined as long-term HbA1c of less than 48 mmol/mol (6.5%) without needing blood glucose-lowering treatments. One of the lead researchers in the study Professor Roy Taylor, from Newcastle University, said: "These results are a significant development, and finally pull down the curtain on the era of type 2 diabetes as an inevitably progressive disease. "We now understand the biological nature of this reversible condition. However, everyone in remission needs to know that evidence to date tells us that your Type 2 diabetes will return if you regain weight. "Even during the second year of freedom from type 2 diabetes there was a highly suggestive difference in major complications of diabetes. The numbers are still small at the moment, and further information on this must be gathered during the planned longer-term follow up."

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I would love someone like Gabor Edosi to analyse these shakes (in my opinion they and protein shakes are the ultimate in processed 'foodstuffs'). Great for clinical trials, suppose, but give me steak and mushrooms any day of the week.
 

bulkbiker

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I would love someone like Gabor Edosi to analyse these shakes (in my opinion they and protein shakes are the ultimate in processed 'foodstuffs'). Great for clinical trials, suppose, but give me steak and mushrooms any day of the week.
Compared to what most people eat they are still "low Carb" I think they end up about 80g per day from the shakes. Also I noted that the first leg of Direct was testing participants for ketones.. can't imagine why!!! I'm guessing the successful participants were in starvation ketosis whilst on the diet too.
What annoys me slightly is that its still being seen as a "success" when now only 35% or so of the intervention trial participants are still reversed after 24 months
 
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[...] only 35% or so of the intervention trial participants are still reversed after 24 months

If one can even call 48mmol/mol HbA1c “reversed”. Personally I’d classify that as getting diabetes, not recovering from it.

That’s an average blood glucose concentration of ~7.8mmol/L. Borderline glucotoxicity now equals diabetes reversal?? :shifty:
 

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I would love someone like Gabor Edosi to analyse these shakes (in my opinion they and protein shakes are the ultimate in processed 'foodstuffs'). Great for clinical trials, suppose, but give me steak and mushrooms any day of the week.

Great, now I'm hungry and find myself defrosting a steak...
 

ringi

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What annoys me slightly is that its still being seen as a "success" when now only 35% or so of the intervention trial participants are still reversed after 24 months

Nearly everyone who took part are still getting lower A1c while taking fewer drugs then they were before. Few GP have ever seen results so good, and it takes very little of the GP time.
 

sunnybouy77

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Nearly everyone who took part are still getting lower A1c while taking fewer drugs then they were before. Few GP have ever seen results so good, and it takes very little of the GP time.
It's all about carb counting
 

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I think the point of these shakes is that they're designed to be a balanced blend of nutrients, which eating steak and mushrooms every day is not. Sadly!

Plus they are super simple to prepare/consume/manage which when you're on an aggressively calorie restricted diet, and presumably are not already very good at calorie control, may not be such a bad thing either.

Ultimately the shakes are manufactured to make a profit. "A balanced blend of nutrients" derived from what?
Hence my wish to get an expert such as Gabor to analyse said.
And unless one plans to stay on these shakes for the rest of one's life then the return to 'normal' foodstuffs still has to be managed. Why not cut out the middleman? NB the exceedingly rich middleman.
 

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I didn't say every day, I said any day of the week. I've seen those shakes on tv, I prefer real food.
 
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I think the point of these shakes is that they're designed to be a balanced blend of nutrients, which eating steak and mushrooms every day is not. Sadly!

Plus they are super simple to prepare/consume/manage which when you're on an aggressively calorie restricted diet, and presumably are not already very good at calorie control, may not be such a bad thing either.

I love steak and mushrooms :hungry: but couldn't it everyday.
 

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Does it say what happened to the nearly 66% of participants who didn't put their T2D into remission ?