Recently reports….Freedom from Diabetes (DIRECT TRIAL 2 yr. data)

It is most unusual to be able to provide a new medical treatment for a major chronic disease which is both health-improving and cost-saving. The DiRECT (The Diabetes Remission Clinical Trial) study has shown that durable remissions of type 2 diabetes to a non-diabetic state can be achieved through an integrated weight management programme, mostly for those achieving weight loss >10 kg, for almost half of all participants. Weight loss >15 kg in the intervention arm led to remissions for 86% at 1 year and 82% at 2 years.

Diabetologia concludes:

It concluded there was ample evidence to support the recommendation of achieving remission through weight loss, but that long-term follow-up was needed given the risk of weight regain. Relapse into diabetes, driven by weight regain, incurs costs from relapse management and from resumption of progressive costs for diabetes and its complications. Though relapse had a bearing on outcomes in our study, even relatively rapid relapse did not alter the conclusion that the low-energy diet intervention was capable of producing long-term health gains without adding long-term costs. The Counterweight-Plus intervention may therefore be expected to be transferable to other diabetes care settings in a similarly cost-effective manner. Incorporating the lifetime healthcare cost savings due to periods of remission from diabetes and its complications, the DiRECT intervention is predicted to be both more effective (QALY gain) and cost-saving in adults with type 2 diabetes compared with standard care. This conclusion appears robust to various less favourable model scenarios, providing strong evidence that resources could be shifted cost-effectively to support achieving remissions with the DiRECT intervention.


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