By Kelly Young

Edited by André Sofair, MD, MPH

Following a structured weight loss plan in a primary care setting can lead to sustained diabetes remission 2 years later, a study in the Lancet Diabetes & Endocrinology finds.

Researchers enrolled roughly 300 patients with a BMI of 27–45 who had type 2 diabetes but weren’t insulin-dependent. Their primary care practices were randomized to deliver either an integrated structured weight management program or standard care. The intervention included diabetes and hypertension drug withdrawal, total diet replacement of 850 calories/day for 12 to 20 weeks, stepped food reintroduction for 2 to 8 weeks, and structured support for maintaining weight loss.

At 12 months, 24% of patients in the intervention group had lost 15 kg or more and 46% had diabetes remission.

By 24 months, weight loss of 15 kg or more was still more common in the intervention group (11% vs. 2% of the control group). Intervention participants also had a greater likelihood of diabetes remission (36% vs. 3%).

The authors write: “Our findings make a strong case that intensive weight management should be included as a first-line option in routine care for people with type 2 diabetes to target early remission from a potentially devastating progressive disease.”