Type 2 diabetes mellitus is common, disabling and expensive, despite improved glucose-lowering management and guidelines. Its dominant cause is weight gain, with ectopic fat accumulation in vital organs, reflected by a large waist circumference. Addressing the underlying cause, by low-calorie formula diets and integrated support for long-term weight-loss maintenance, produces remissions in almost half the treated population.
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References
Xin, Y. et al. Within-trial cost and 1-year cost-effectiveness of the DiRECT/counterweight-plus weight-management programme to achieve remission of type 2 diabetes. Lancet Diabetes Endocrinol. 7, 169–172 (2019).
Taylor, R. et al. Remission of human type 2 diabetes requires decrease in liver and pancreas fat content but is dependent upon capacity for β cell recovery. Cell Metab. 28, 1–10 (2018).
Dixon, J. B. et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomised controlled trial. JAMA 299, 316–323 (2008).
Lean, M. E. et al. Obesity, weight loss and prognosis in type 2 diabetes. Diabet. Med. 7, 228–233 (1990).
Franz, M. J. et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J. Am. Diet. Assoc. 107, 1755–1767 (2007).
Lean, M. E. J. et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open label, cluster randomised trial. Lancet 391, 541–551 (2018).
Purcell, K. et al. The effect of rate of weight loss on long-term weight management: a randomised controlled trial. Lancet Diabetes Endocrinol. 2, 954–962 (2014).
Leslie, W. S. et al. Weight losses with low-energy formula diets in obese patients with and without type 2 diabetes: systematic review and meta-analysis. Int. J. Obes. 41, 96–101 (2017).
Lean, M. & Hankey, C. Keeping it off: the challenge of weight loss maintenance. Lancet Diabetes Endocrinol. 6, 681–683 (2018).
McCombie, L. et al. Filling the intervention gap: service evaluation of an intensive nonsurgical weight management programme for severe and complex obesity. J. Hum. Nutr. Diet. https://doi.org/10.1111/jhn.12611 (2018).
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M.E.J.L. has consulted for Counterweight Ltd, with fees paid to the University of Glasgow.
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Lean, M.E.J. Low-calorie diets in the management of type 2 diabetes mellitus. Nat Rev Endocrinol 15, 251–252 (2019). https://doi.org/10.1038/s41574-019-0186-6
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DOI: https://doi.org/10.1038/s41574-019-0186-6
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