Total Diet Replacement proven to be effective in insulin-treated type 2 diabetes

Posted On: 3rd February 2020

Total Diet Replacement proven to be effective in insulin-treated type 2 diabetes

TDMR Europe welcomes the publication of a clinical trial that confirms that total diet replacement (TDR) can be used safely and effectively in people with more advanced insulin-treated diabetes as well as those with early diabetes who can be put into remission by TDR followed by effective weight maintenance, as shown in the DiRECT trial.

Our chairman, Professor Anthony Leeds a co-author of the study, has provided a short description of the work:

An 800kcal/d total diet replacement (TDR) was used for 12 weeks followed by food reintroduction with behaviour modification and exercise in insulin-treated people with type 2 diabetes and was compared with a standardised dietetic intervention that aimed at a 600kcal/d deficit over 12 months (there were 45 people in each group). In the TDR group mean weight lost at 1 year was 9.8kg compared to 5.6kg in the standardised care group, and nearly 40% were no longer using insulin one year later, compared to 6% in the standardised care group. The TDR group also showed a greater improvement in blood glucose control and a significant improvement of quality of life. Episodes of hypoglycaemia were no more frequent in the TDR treated group than in the standard diet group.

With increasing numbers of people with type 2 diabetes, increasing overall medication and treatment costs and increasing costs of insulin treatment the UK and all European countries need a safe, effective way to reduce the spiralling health-care costs, and the suffering, caused by type 2 diabetes.

The evidence for the efficacy of TDR in early and insulin-treated diabetes should be reviewed by authorities who generate clinical guidelines. Educational programmes to help doctors, dietitians and nurses to use TDR effectively need to be developed further (see: ). Collaboration between healthcare providers and the commercial sector should be developed further based on the results of the DROPLET trial (see: ) and it’s health economics analysis ( see: ).

Low-energy total diet replacement intervention in patients with type 2 diabetes mellitus and obesity treated with insulin: a randomised trial. Brown A, Dornhorst A, McGowan B, Omar O, Leeds AR, Taheri S, Frost G. (2020). BMJ Open Diabetes research and Care doi:10.1136/bmjdrc-2019-001012 (published 28 01 2020)

The study was funded by Cambridge Weight Plan Ltd., a member of TDMR Europe, and used Cambridge Weight Plan products.