An ongoing UK national prospective program shows remission of type 2 diabetes (T2D) outside of research settings, through at-scale service delivery. Between Sept 1, 2020, and Dec 31, 2022, 7540 people (aged 18–65 years diagnosed with T2D within the last 6 years) were referred, 1740 started total diet replacement (TDR) before January 2022 and had a full 12-month opportunity to undertake the program by the time of data extraction at the end of December 2022. The TDR phase for 12 weeks with a total daily calorie intake of around 800–900 kcal was followed by a period of food reintroduction for 4–6 weeks and the final phase of weight maintenance with coaching sessions. There were 960 (55%) completed the program (defined as having a weight recorded at 12 months). The mean weight loss for the 1710 participants who started before January 2022 and the 945 participants who completed the program with no missing data was 8·3% or 9·4 kg, and 9·3% or 10·3 kg, respectively. For the subgroup of 710 (42%) of 1710 participants who started the program before January 2022, and had two HbA1c measurements recorded, 190 (27%) had remission, with mean weight loss of 13·4% or 14·8 kg. Of the 945 participants who completed the program, 450 (48%) had two HbA1c measurements recorded; of these, 145 (32%) had remission, with mean weight loss of 14·4% or 15·9 kg. The likelihood of reaching remission was greater for those with greater weight loss, those within 1 year of diagnosis, and those with lower baseline HbA1c values. The findings complement the clinical efficacy findings from randomized controlled trial settings, providing important evidence on the clinical effectiveness of the TDR approach when delivered at scale in real-world settings. Source: https://www.thelancet.com/
