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Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT

The prognosis for people with type 2 diabetes (T2D) remains concerning, yet its seriousness is often underestimated. T2D is a manifestation, in susceptible individuals, of the disease-process of obesity, and at diagnosis, 10-year survival rates for T2D are around 50%. Here, we will examine: (a) the...

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Autores principales: Noronha, Jarvis C., Thom, George, Lean, Michael E. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202990/
https://www.ncbi.nlm.nih.gov/pubmed/35721753
http://dx.doi.org/10.3389/fendo.2022.888557
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author Noronha, Jarvis C.
Thom, George
Lean, Michael E. J.
author_facet Noronha, Jarvis C.
Thom, George
Lean, Michael E. J.
author_sort Noronha, Jarvis C.
collection PubMed
description The prognosis for people with type 2 diabetes (T2D) remains concerning, yet its seriousness is often underestimated. T2D is a manifestation, in susceptible individuals, of the disease-process of obesity, and at diagnosis, 10-year survival rates for T2D are around 50%. Here, we will examine: (a) the role of weight loss in T2D, (b) use of total diet replacements (TDRs) to induce weight loss, (c) the Diabetes Remission Clinical Trial (DiRECT) protocol and key results, (d) other dietary interventions related to T2D remission, (e) remission in real life, and (f) future directions. Remission of short-duration T2D will usually require 10-15% body weight loss, and results from the DiRECT trial demonstrated that this can be achieved within routine care in nearly half of all people undertaking a supported, TDR-led behavioural weight management programme. In light of these findings, which have since been replicated in the Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I) trial conducted in the Middle East and North Africa, it is now time to prioritize weight loss programmes for T2D remission from diagnosis, and with increasing acceptance and availability of digital healthcare, there is an opportunity to scale up delivery of remission programmes in a cost effective manner.
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spelling pubmed-92029902022-06-17 Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT Noronha, Jarvis C. Thom, George Lean, Michael E. J. Front Endocrinol (Lausanne) Endocrinology The prognosis for people with type 2 diabetes (T2D) remains concerning, yet its seriousness is often underestimated. T2D is a manifestation, in susceptible individuals, of the disease-process of obesity, and at diagnosis, 10-year survival rates for T2D are around 50%. Here, we will examine: (a) the role of weight loss in T2D, (b) use of total diet replacements (TDRs) to induce weight loss, (c) the Diabetes Remission Clinical Trial (DiRECT) protocol and key results, (d) other dietary interventions related to T2D remission, (e) remission in real life, and (f) future directions. Remission of short-duration T2D will usually require 10-15% body weight loss, and results from the DiRECT trial demonstrated that this can be achieved within routine care in nearly half of all people undertaking a supported, TDR-led behavioural weight management programme. In light of these findings, which have since been replicated in the Diabetes Intervention Accentuating Diet and Enhancing Metabolism (DIADEM-I) trial conducted in the Middle East and North Africa, it is now time to prioritize weight loss programmes for T2D remission from diagnosis, and with increasing acceptance and availability of digital healthcare, there is an opportunity to scale up delivery of remission programmes in a cost effective manner. Frontiers Media S.A. 2022-06-02 /pmc/articles/PMC9202990/ /pubmed/35721753 http://dx.doi.org/10.3389/fendo.2022.888557 Text en Copyright © 2022 Noronha, Thom and Lean https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Noronha, Jarvis C.
Thom, George
Lean, Michael E. J.
Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title_full Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title_fullStr Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title_full_unstemmed Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title_short Total Diet Replacement Within an Integrated Intensive Lifestyle Intervention for Remission of Type 2 Diabetes: Lessons From DiRECT
title_sort total diet replacement within an integrated intensive lifestyle intervention for remission of type 2 diabetes: lessons from direct
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202990/
https://www.ncbi.nlm.nih.gov/pubmed/35721753
http://dx.doi.org/10.3389/fendo.2022.888557
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