Remission of type 2 diabetes at 2 years
- Published in
- Lancet Diabetes Endocrinol 2019
- People studied
- 298
In the DiRECT trial of people with type 2 diabetes diagnosed in the past 6 years, 36% in a diet programme were in remission after 2 years, against 3% with usual care.
- Checked against
- PubMed 30852132
- Published in
- Lancet Diabetes Endocrinol 2019
- Last checked
- 30 October 2026
Key takeaway
DiRECT, in UK family practices, enrolled 298 adults aged 20 to 65 who had type 2 diabetes for less than 6 years and a BMI of 27 to 45. The programme was a formula diet (shakes and soups) of about 825 to 853 calories a day for 12 to 20 weeks, then food reintroduction and support to keep the weight off. Remission means blood sugar back below the diabetes range. After 1 year 46% of the programme group were in remission, and after 2 years 36% were, against 3% with usual care.
At a glance
- Type of study
- randomised trial in which whole practices were assigned to a group (DiRECT, 2-year results)
- People studied
- 298
- How long
- 2 years
- Compared with
- best-practice usual care
- Main result
- 36% in remission at 2 years, against 3% with usual care.
- Strength of evidence
- Randomised trials
What this study does not show
Remission fell from 46% at 1 year to 36% at 2 years, and went with how much weight people kept off. Looking back across the whole study, 29 of the 45 people who kept off at least 10 kg were in remission. Both participants and staff knew who was in which group, and only people with a fairly recent diagnosis took part.
Results from studies in groups of people, mostly in diet and movement programmes. They cannot be promised to any one person. This information is educational and does not replace a consultation with a doctor.
More on metabolism
- Lower diabetes risk with each kiloLong-term or observational studies · Hamman et al., Diabetes Care 2006
- Better insulin responseSmall or uncontrolled studies · Magkos et al., Cell Metab 2016
- Half as many new diabetes casesRandomised trials · Tuomilehto et al., NEJM 2001
- More than 5% for clearer blood sugar gainsRandomised trials · Franz et al., J Acad Nutr Diet 2015
- More diabetes remission with fewer caloriesRandomised trials · Jayedi et al., Am J Clin Nutr 2023
- Remission of type 2 diabetes at 2 yearsRandomised trials · Lean et al., Lancet Diabetes Endocrinol 2019
- Fewer new cases of type 2 diabetesRandomised trials · Ruiz-Canela et al., Ann Intern Med 2025
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