Research in context
Evidence before this study
Before undertaking the Diabetes Remission Clinical Trial (DiRECT) study, we searched PubMed for evidence on remissions of type 2 diabetes with all potential interventions. For the present analysis, we reviewed new literature on remission of type 2 diabetes through weight management, searching PubMed for articles published in English since the publication of the 12-month results of DiRECT (December, 2017) up to Dec 31, 2018, using search terms “clinical trial”, “remission”, “type 2 diabetes”, and “weight loss”. The search identified eight reports, of which only three covered weight-loss interventions; of these, two were reports from DiRECT and one reported results of laparoscopic surgery, which was deemed not relevant.
Added value of this study
The present study extends to 2 years evidence for durable remission of type 2 diabetes following diet-induced weight loss. The results also provide evidence of wider benefits relating to blood pressure, blood lipids, and wellbeing.
Implications of all the available evidence
The findings from DiRECT will provide added impetus to extend the early measures already announced to change existing National Health Service policy and practice for the routine management of type 2 diabetes. These data, and other relevant data on diabetes control, HbA1c, and weight management, all point towards the likelihood that intensive weight management has the potential to reduce or delay complications of type 2 diabetes and improve clinical outcomes.