New findings from the three-year extension of the groundbreaking diabetes remission clinical trial DiRECT show that patients whose type 2 diabetes was in remission at the end of the second year of the original study remained in remission at year five. It was found that 26% were still in remission. The overall remission rate was 13% for patients with 5-year data.
The five-year results break new ground, showing that the number of serious medical events requiring hospitalization was halved in patients who received the dietary intervention. Additionally, the longer participants were able to maintain a low body weight and maintain type 2 diabetes remission, the less likely they were to suffer from diabetes-related medical complications.
Important new findings published in The Lancet Diabetes & Endocrinology show how effective weight management and dietary programs are in controlling and remitting type 2 diabetes, and suggest that diet-based treatments for type 2 diabetes highlights the critical need to increase clinical investment in disease. Research is particularly needed to help maintain the long-term weight loss needed to achieve remission and other health benefits.
Designed and maintained by researchers. university of glasgow and newcastle and was funded by diabetes uk, the DiRECT trial proved to be highly effective in lowering blood pressure, reducing the need for antihypertensive drugs, and bringing about remission in type 2 diabetes. At DiRECT, we put you on an 830 calorie formula diet for 12 weeks to help you lose weight, then gradually transition your regular diet back to a healthy diet to help you maintain your weight loss. This landmark trial is the first to show that a dietary intervention program in primary care can bring his type 2 diabetes into remission, with almost half (46%) achieving remission at 1 year and 36% The disease went into remission in two years. Weight decreased by more than 10 kg, and 75% (three quarters) of intervention group participants were in remission in both his first and her second year.
To investigate how much weight loss and remission can be sustained over the first two years of the trial, and whether there are broader health benefits, the DiRECT-Extension study tested a low-intensity weight loss maintenance support program. was provided to 95 participants. Remains from the original his DiRECT trial. Over a three-year period, participants received appointments in their respective workplaces. GP They had their weight, blood sugar levels and blood pressure checked every three months, either during surgery or remotely during the coronavirus lockdown, and were given advice and support to maintain their weight loss.
DiRECT-Extension results demonstrated the continued effectiveness of long-term weight management for control and remission of type 2 diabetes. However, some participants experienced significant weight gain, particularly by the third year, indicating difficulty in maintaining weight loss and the need to find new ways to provide this type of support to patients. Gender was highlighted. But importantly, those who remained in remission achieved an average weight loss of 8.9 kg after five years.
Overall, at 5 years, those in the DiRECT-Extension group lost an average of 6.1 kg. Those in his original DiRECT control group, who were on routine diabetes treatment but given explicit advice to lose weight, lost an average of 4.6 kg. The original intervention group was more likely than the original control group to have a 5-year weight that was more than 5% below baseline (61% vs. 29%). HbA1c below the diabetes threshold of 48 mmol/mol (29% vs 15%), did not require antidiabetic drugs (51% vs 16%), and were in remission (27% vs 4%). Of the patients who were in remission at 2 years, more than a quarter (26%) remained in remission at 5 years.
Consistent with results from other studies, the 5-year results also suggested widespread health benefits from the dietary intervention. Participants in the original DiRECT intervention group had less than half the number of illnesses requiring hospitalization (4.8 per 100 patient-years) and fewer diabetes-related illnesses than the original DiRECT control group (10.2 per 100 patient-years). There were fewer clinical symptoms.lower in events where weight loss was maintained HbA1c And remission.
Professor Mike Leen“This is a significant step forward in our research,” said Co-designer of the original DiRECT trial and lead author of the latest DiRECT-Extension study. Excess or abnormal accumulation of body fat. When fat accumulates in vital organs such as the liver, pancreas, and heart, these organs cannot function properly. Weight loss of 10-15 kg (approximately 2 stone) is sufficient to remove abnormal fat from vital organs and is the key to type 2 remission.
“DiRECT has led to a global paradigm shift in the understanding and treatment of type 2 diabetes. The disease is not necessarily permanent, and these five-year results demonstrate that weight loss can be improved to achieve periods of remission. The results suggest that a diet designed to help people with diabetes is more likely to be free from some diabetes complications and result in fewer people being hospitalized with medical problems.
“We must now call for more effective, long-term funding for research to improve these outcomes, and in particular to prevent weight gain. But this evidence… This means that we should no longer just lower high blood sugar levels with drugs, but should also prioritize effective weight management and seek to check the underlying disease process when diagnosed with type 2 diabetes. Previous research has shown that people with type 2 diabetes who are not overweight have excess or abnormal body fat and may be able to achieve remission with fairly modest weight loss. New drugs being developed for type 2 diabetes and obesity are exciting, but they should not be prescribed without proper dietary weight management.”
Professor Roy Taylorco-designer of the original DiRECT trial and senior author of the latest DiRECT-Extension study, from the University of Newcastle, said: “This five-year study shows that long-term remission of type 2 diabetes is possible if sufficient weight loss is achieved and maintained.”
“Regardless of whether diabetes remission was achieved, those assigned to the weight loss group had less than half the serious health problems that the conventional treatment group experienced. It should help us change the way we manage things.”
Dr. Elizabeth RobertsonDirector of Research at Diabetes UK said: “Diabetes UK is proud to have funded over a decade of research that has broken new ground for people with type 2 diabetes and put remission on the map. Easing the burden of 365-day diabetes management will transform your health and well-being. But we know that getting into remission is difficult, and staying in remission is even harder. we, New remission information and support hub And we continue to fund research to understand how to help more people get into remission and stay in remission for longer. ”
The study, “Five-Year Follow-up of the Randomized Diabetes Remission Clinical Trial (DiRECT): An Extension Study of Continuous Support for Weight Loss Maintenance,” was published in The Lancet Diabetes & Endocrinology. This research was funded by Diabetes UK.
More information about DiRECT and remission resources can be found at:
https://www.directclinicaltrial.org.uk/
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