Completed Diabetes, Hormones & Metabolism Public Health & Healthcare

Reversal of T2DM using non-surgical weight management with Low-Energy-Liquid-Diet and long-term maintenance, within routine NHS care

Funder DiabetesUK Charity-funded
Recipient organisation University of Glasgow
Funding £2.3M
Period Oct 2013 — Sept 2018

In plain English

AI plain-English summary

A structured weight-loss programme using meal replacement shakes is being tested in NHS GP surgeries to see if it can reverse type 2 diabetes in routine care, not just in specialist research clinics. Small, intensive studies have already shown that losing a large amount of weight can send type 2 diabetes into remission. But those studies were tightly controlled and used resources that are not available in everyday primary care. This trial asks whether the same approach can work at scale, with practice nurses and dietitians delivering the programme. It also investigates *why* remission happens—by measuring fat in the liver and pancreas, and how the beta cells that produce insulin recover. If the programme works, it could change how the NHS treats newly diagnosed type 2 diabetes. Instead of a lifetime of medication, patients might be offered a time-limited, non-surgical route to remission. The study also tracks patients for two years, so it will reveal whether the weight loss—and the remission—can be maintained. And by interviewing patients and GPs about their attitudes, the researchers will identify the real-world barriers that could stop the programme from being adopted, even if the science is sound.

View original technical description
Type 2 diabetes (T2DM) has been shown to be reversible in small, intensive studies. This study will test the applicability of this knowledge to the wider population of people with T2DM managed routinely in Primary Care, and define underlying mechanisms, barriers to achievement of reversal. Data will be collected for future cost-effectiveness analysis. Design: WP 1: 24-month practice-based Cluster-Randomised Trial of an intensive structured weight-management programme for T2DM patients to compare Low Energy Liquid Diet (LELD) with long-term weight-maintenance vs. standard diabetes/weight management. WP 2: In a subset of WP 1 intra-organ triglyceride, beta cell function and VLDL secretion will be measured to elucidate mechanisms of diabetes reversal. WP 3: Qualitative research on attitudes, beliefs and quality of life among trial participants to define the barriers, and potential incentives, to using intensive medical weight management in routine diabetes care. Attitudes of GP's to the intervention will also be assessed. Setting: NHS Primary Care, with Counterweight Team training for practice nurses/dietitians. Co-Primary Outcomes: % achieving >15kg weight loss, and achievement of normal HbA1c ( 27 kg/m2, on diet +/-OHA, within 6 years of type-2 diabetes diagnosis.

View the original record at the funder ↗

Researchers

Michael Lean (EPMC Awardee)

Related Research

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Dietary Approaches to the Management Of type 2 Diabetes (DIAMOND) cluster randomised trial
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Economic Evaluation of the Diabetes Remission Clinical Trial DiRECT
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Original classification

Strategic Research grant

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