Remission of type 2 diabetes means that your blood glucose levels are below the diabetes range, without you needing to take any diabetes medication.
For remission to be confirmed, your long-term blood test (HbA1c) would be <48mmol/mol (6.5%) for at least six months without medications.
Some people call this reversing type 2 diabetes. We use the term remission as diabetes can come back. It’s important to continue to maintain lifestyle changes and keep your diabetes appointments while in remission.
See Diabetes UK for more information on type 2 diabetes remission.
How to achieve remission
Research has shown that rapid weight loss and support to maintain this significantly increases your chances of achieving and sustaining type 2 diabetes remission.
The Diabetes Remission Clinical Trial (DiRECT) used the Counterweight Plus Programme and found that rapid weight loss of 15kg (2st 7 lbs) and support to maintain weight loss gave the best chance of type 2 diabetes remission.
For more information see the DiRECT website.
Eligibility
To be considered for Total Diet Replacement Diabetes Remission programme, you will:
- have been diagnosed with type 2 diabetes for six years or less
- be 18 to 65 years old
- have a BMI over 27kg/m2 (Caucasian ethnicity) or over 25kg/m2 (Asian ethnicity)
- have a HbA1c of 48mmol/mol or above (not on diabetes medications)
- have a HbA1c of 43mmol/mol or above (on diabetes medications)
- not manage your diabetes with insulin
- be ready to make lifestyle changes and commit to attending 20 appointments over the year
There are other medical conditions that may mean you cannot be considered for the Diabetes Remission Programme. These can be discussed with a member of the team.
What the programme involves
Total Diet Replacement Diabetes Remission is a clinically proven, intensive weight management programme.
It has a total diet replacement stage, followed by gradual food reintroduction and weight maintenance stages.
The programme is available in NHS Ayrshire and Arran and is delivered by specialist dietitians who will support people to achieve diabetes remission. The three key stages over the 12 months are supported by regular appointments with the dietitian.
Stage 1: Total Diet Replacement
Two weeks of shakes and soups. Approximately 830kcals per day.
Rapid weight loss and time away from usual diet
Goal setting and support with managing difficult situations.
Appointments with the dietitian every two weeks
Stage 2: Food Re-introduction
Introduction of meals with gradual reduction of soups and shakes
Support with meal and activity planning
Personal dietary and weight loss goals
Appointments with the dietitian every two weeks
Stage 3: Weight Maintenance
Support to maintain weight loss goals
Positive behaviour change strategies reinforced
Lifestyle changes for long term health
Appointments with the dietitian every month
On average, those who complete counterweight plus programme lose 16.9kg.
Is the programme right for me?
This is an intense weight management programme.
You will be invited to opt in to an initial appointment with the team. This will involve a series of questionnaires to ask about your physical and mental health, your history and your expectations of managing your weight and diabetes.
We need you to be ready to take an active role and commit to attending all three stages of the programme.
Motivation to make changes in your life will vary depending on what else is going on for you. It is important to think about whether now is the right time to start making changes.
Testimonials
“Couldn’t wait until next week to let you know that I weighed myself this morning and measured 81.3kg … I round that to achieving my 10% goal for Christmas”
“Feel great, very positive and motivated by my results”
“I am so happy to be off my blood pressure and blood glucose medications”
“Completely changed my way of thinking about food, feel more confident since losing weight I have started cycling again which is something I haven’t done in years. Cycled 60 miles last week!”
“Less breathless walking up hills before I would avoid hills, now I just go for it. I am sleeping better and feel great. I am off of my inhaler for COPD, off all my diabetes tablets and blood pressure tablets”
“The pain in my feet has stopped now. They used to be painful when I put them on the ground in the morning. I’m walking faster and feeling much more mobile”
Find out more
To find out how you can participate in the programme contact your family doctor (GP).
Contact
NHS Ayrshire and Arran Diabetes Dietitians: aa.clinicalspecialty.nutritiondietetictdr@aapct.scot.nhs.uk