Diabetes Remission Possible With Primary Care Weight Loss Program

A structured weight loss plan in the primary care setting could lead to sustained remission of diabetes, according to the results of a recent study.

To examine the long-term effects of a primary care-led weight-management program, researchers conducted an open-label, cluster-randomized, controlled trial involving individuals aged 20 to 65 years with less than 6 years duration of type 2 diabetes, BMI of 27–45 kg/m 2, and who were no receiving insulin between July 25, 2014 and August 5, 2016. The participants (n = 298) were randomly assigned to either the structured weight management program or standard care. The program included diabetes and hypertension drug withdrawal, total diet replacement for 12 to 20 weeks, stepped food reintroduction for 2 to 8 weeks, and structured support for weight-loss maintenance.

At 12 months, 17 participants (11%) in the intervention group and 3 participants (2%) in the control group had weight loss of at least 15 kg, and 53 participants (36%) in the intervention group and 5 participants (3%) in the control group had remission of diabetes.

“The DiRECT program sustained remissions at 24 months for more than a third of people with type 2 diabetes. Sustained remission was linked to the extent of sustained weight loss,” the researchers conclude.

—Michael Potts

Reference:

Lean MEJ, Leslie WS, Barnes AC, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial [published online March 6, 2019]. Lancet Diabetes and Endocrinology. doi: https://doi.org/10.1016/S2213-8587(19)30068-3