Energy balance
Structured low-calorie total diet replacement (825–853 kcal/day) for 12–20 weeks followed by food reintroduction can induce remission of type 2 diabetes in a significant subset of patients, defined as HbA1c <48 mmol/mol without diabetic medications.
If you have Type 2 Diabetes and obesity, ask your doctor about a Total Diet Replacement (TDR) program. This involves consuming 825-853 calories a day for 3-5 months using specific meal replacements, followed by a gradual return to solid foods. This approach has been shown to put diabetes into remission for over a third of participants, especially if you lose 10kg or more. It requires medical supervision to adjust your diabetes medications safely.
The control group received best-practice diabetes care while the intervention group received a structured weight management programme and total diet replacement (825–853 kcal/day) for 12–20 weeks... At 24 months, 36% of intervention participants achieved remission of diabetes (defined by HbA1c <48 mmol/mol on no diabetic medications).
Why this rating
Based on the DiRECT trial, a cluster-randomized trial, which is high-quality evidence, though the paper is a review summarizing it.
Source
Managing obesity in people with type 2 diabetes
Bonnie Grant et al. · Clinical Medicine · 2021
DOI 10.7861/clinmed.2021-0370
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Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
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