Soup and Shake Diet Intervention Effective in Attaining Type 2 Diabetes Remission , claims Lancet study

A new study published in The Lancet Diabetes & Endocrinology journal suggests that through at-scale service delivery, type 2 diabetes can be remitted outside of research settings. Total diet replacement (TDR) has been found in randomized controlled studies to be effective in type 2 diabetes remission. The NHS Type 2 Diabetes Path to Remission (T2DR) program, a 12-month behavioral intervention to support weight loss that involves an initial 3-month period of TDR, was developed in response to the English National Health Service's (NHS) 2019 commitment to establishing a TDR-based interventional program delivered at scale within real-world environments. Thus, this study by Jonathan Valabhji and colleagues evaluated program participants of type 2 diabetes remission.

As part of a nationwide prospective service assessment the people in England between the ages of 18 and 65 who had been diagnosed with type 2 diabetes within the previous 6 years. The National Diabetes Audit and program data were connected to determine HbA1c values and prescriptions for medications that decrease blood sugar. Remission of type 2 diabetes at 1 year was the main outcome, which was outlined as two HbA1c measurements of less than 48 mmol/mol reported at least 3 months apart and no prescription for glucose-lowering drugs starting 3 months prior to the first HbA1c measurement and the second HbA1c measurement recorded 11 to 15 months after the start of program.

A total of 7540 participants were referred to the program between September 1, 2020, and December 31, 2022. Of which, 1740 began TDR prior to January 2022, giving them a full year to complete the program by the time data extraction took place at the end of December 2022. 960 people (55%) of the participants who began TDR prior to January 2022, finished the program.

There was an average weight reduction of 8·3% or 9·4 kg for the 1710 individuals who began the program before January 2022 and had no missing data, and an average weight loss of 9·3% or 10·3 kg for the 945 participants who finished the program and had no missing data. In a subset of 710 (42%) of 1710 patients who began the treatment before January 2022 and had two HbA1c measures recorded, 190 (27%) experienced remission, with a mean weight reduction of 13·4% or 14·8 kg. Of the 945 patients who finished the program, 450 (48%) had two HbA1c values recorded. 145 (32%) experienced remission, with a mean weight reduction of 14·4% or 15·9 kg.

Source:

Valabhji, J., Gorton, T., Barron, E., Safazadeh, S., Earnshaw, F., Helm, C., Virr, M., Kernan, J., Crowe, S., Aveyard, P., Wilding, J., Willis, T., Ells, L., O’Neill, S., Robertson, E., Jebb, S., Taylor, R., & Bakhai, C. (2024). Early findings from the NHS Type 2 Diabetes Path to Remission Programme: a prospective evaluation of real-world implementation. In The Lancet Diabetes & Endocrinology. Elsevier BV. https://doi.org/10.1016/s2213-8587(24)00194-3