World Health Day, 7 April 2021 – Universal Health Coverage: everyone, everywhere

Posted On: 7th April 2021

TDMR Europe welcomes the World Health Organisation’s ‘World Health Day’ that commemorates the founding of WHO in 1948.  This year the theme reflects the disparities in healthcare available to different groups across the globe, brought into sharp focus by the COVID19 crisis, and reflects a desire to make healthcare truly universal.

Recognising that the burden of suffering of type 2 diabetes mellitus (T2DM) and related health-care costs will rise disproportionately in low and middle-income countries, TDMR Europe notes that effective prevention and early T2DM remission ought to be a part of any national healthcare programme.  Several T2DM prevention programmes show that weight reduction is the most important component of T2DM prevention, along with increased physical activity and optimal composition of the maintenance diet.  The more weight that can be lost the greater the reduction in numbers of people developing T2DM we can expect to see.  Despite this clear evidence, there are only a few T2DM prevention programmes that effectively deliver large weight losses (7-10% of body weight).  The PREVIEW diabetes prevention programme has shown that a large initial weight loss of an average 10% body weight with Total Diet Replacement (TDR) followed by a structured diet focussing on glycaemic index and higher protein content, delivered fewer cases of T2DM 3 years later than would have been expected.  The next practical challenge is to introduce PREVIEW-style initial weight loss with TDR and lower GI, lower glycaemic load and higher protein maintenance diet into the T2DM prevention programmes of many more countries.

Early T2DM remission programmes, that incorporate an initial large weight loss with TDR, could also be offered in more countries than is currently the case.  Within the UK, Scotland and England currently have such programmes in early stages, as does Abu Dhabi and Qatar in the middle East, and there are a small number of diabetes remission clinics in South East Asia.

However, there is clearly much more to do. In addition to generating first class clinical trial evidence there is a need to share knowledge and experience in the use of TDR weight loss followed by effective weight maintenance.  To this end TDMR chairman, Professor Anthony Leeds recently spoke to Professor Mike Lean, principal investigator of the DiRECT diabetes remission trial, in two programmes on the EAWAZ TV channel.

Introducing the programmes Professor Leeds said ‘I am greatly encouraged by the interest shown globally in this type of intervention especially in parts of the world with very high rates for obesity and T2DM, such as Malaysia and the Arabian Gulf States. I am glad that Prof Shahrad Taheri has conducted the DIADEM-1 study in Qatar demonstrating that people of Middle Eastern and North African origin were able to successfully follow TDR weight loss and maintenance and go into T2DM remission in many cases. The stage is set for weight loss with TDR followed by structured weight maintenance programmes to help address this global challenge.’


Watch the interviews with Professor Mike Lean at:  and

For further information on diabetes remission and the DiRECT trial see:

For a diabetes risk calculator go to:

For more details and references on the PREVIEW study go to:

For more details on the DiRECT study go to:

For more details on the DIADEM-1 study go to: