On the 5th December 2017 the 12 month primary outcome results of the Diabetes Remission Clinical Trial (DiRECT) were presented at the International Diabetes Federation Congress hosted in Abu Dhabi. Talks were delivered by both Professor Roy Taylor and Professor Mike Lean, with both pictured here with Professor Naveed Sattar enjoying some refreshments following the event.
Information and resources for weight loss and remission of type 2 diabetes are listed further down this page.
*Updated to include links to Counterweight and The Lean Team documentation
DiRECT is a research study investigating whether offering an intensive programme for weight loss and weight loss maintenance would be advantageous for people with Type 2 diabetes. Specifically, this programme aims to increase the number of people who can become non-diabetic. Participants are recruited only via NHS General Practices which are taking part in the study, and individuals cannot be accepted in DiRECT. General Practices are randomly allocated to offer their patients one of two treatments. Each treatment has already been shown to be effective, and the question of DiRECT is whether one is better than the other. All participants will be followed for at least 2 years, to see how many remain diabetic under each treatment, and how that relates to their weight. Some participants will also undergo detailed tests concerning the amount of fat in their liver and pancreas.
DiRECT is the largest research study, to date, ever supported by the charity Diabetes UK. Additional support is provided by Cambridge Weight Plan pro bono but with no input into study design, execution or analysis. It is being conducted in NHS primary care practices in Scotland and in Tyneside, the intervention being delivered by NHS staff in routine practice. Defined training for these staff is being provided using the Counterweight Plus approach. The NHS “sponsor” is NHS Greater Glasgow and Clyde
Recruitment Status: Recruitment Closed
Funder: Diabetes UK
Primary Sponsor: NHS Greater Glasgow and Clyde(UK)
Recruitment countries: United Kingdom
Health condition studied: Type 2 Diabetes, Nutritional, Metabolic, Endocrine
Target Sample size: 280
URL: NHS DiRECT webpage
Study Protocol DiRECT Protocol
There are several types of diabetes. All are metabolic disorders which can result in progressive damage to the main organs in the body. Diabetes especially damages the heart, brain, feet and legs, eyes, kidneys and nerves. There are two main types of diabetes: Type 1 (caused by an immune attack destroying the pancreas cells which make insulin), and Type 2 (caused by being overweight and resistant to the effect of insulin, with gradual loss of ability to make enough insulin). DiRECT is researching the treatment of Type 2 diabetes, which is the most common type, and the most expensive for health services.
Some people with Type 2 diabetes can become non-diabetic again, at least for a period.
That is called a remission of diabetes. A remission of diabetes will allow the patient to stop taking anti-diabetic drugs.
This is important as the drugs are inconvenient and can cause side-effects.
Also these drugs cost the NHS around £800million per year.
If diabetes remission is long term this would prevent or delay the long-term damage which diabetes causes in different body-organs. The mechanisms underlying the return of normal glucose control will also be examined in the Tyneside cohort. Detailed tests using magnetic resonance scans and insulin secretion tests will be carried out.
A new treatment programme which helps to produce remissions in type 2 diabetes could therefore be advantageous for people with diabetes, and also save treatment costs. For people who achieve a long term remission, the effect upon their future health and well being could be very great indeed.