Remission of Type 2 Diabetes After Total Diet Replacement: Durability, Relapse and the Conversations Nobody Schedules
DOI:
https://doi.org/10.5281/zenodo.22258239Keywords:
Type 2 diabetes, Remission, Total diet replacement, Relapse, Weight-loss maintenanceAbstract
Remission of type 2 diabetes through weight loss is now an established finding rather than a claim, and the question has moved
from whether it happens to how long it lasts. In a randomised trial conducted across 49 general practices, 46 per cent of the
intervention group were in remission at 12 months against 4 per cent of controls. At 24 months the figure was 36 per cent, and at
five years 10 per cent of the intervention group against 5 per cent of controls. Of the 68 participants in remission at 12 months, 20
(29 per cent) had relapsed by 24 months, having regained 7.1 kg against 4.2 kg among those who did not, a difference that did not
reach conventional significance. Remission tracked weight lost rather than anything else: none of the 76 participants who gained
weight achieved it, against 34 per cent of the 56 who lost 5 to 10 kg. Among those offered continued support to year five, 34 per
cent of recorded visits showed remission against 12 per cent without. This review sets out what the trajectory means for what
patients are told at the outset.
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