Research shows TDR’s role in tackling obesity and type 2 diabetes in primary care setting

Posted On: 15th May 2024

The effectiveness of total diet replacement (TDR) in tackling obesity and improving comorbidities, such as type 2 diabetes (T2DM), has been well established by a number of trials over the last few years. Last month, we saw the publication of a series of ground-breaking studies showing that weight loss and T2DM remission in people with obesity using TDR can also be achieved outside research settings.

On 18th April, at the 2024 edition of the Diabetes UK Conference, Professor Jonathan Valabhji, from Imperial College London, presented the remission rates of T2DM at one year for participants in the English National Health Service (NHS) Type 2 Diabetes Path to Remission Programme pilots (formerly known as the NHS Low Calorie Diet Programme), from September 2020 to December 2022. Based on the DiRECT and DROPLET trials, these pilots included an initial 12-week TDR phase, followed by support with food re-introduction and weight maintenance for a total programme duration of one year.

Prof Valabhji explained that 27% of 710 people who had finished the programme by December 2022 had achieved diabetes remission. For participants achieving remission, the mean weight loss was 14.8kg. According to Prof Valabhji, those who lost more weight (>15kg) achieved remission in 55% of people. Following the success of the pilots, the Type 2 Diabetes Path to Remission Programme is to become available across the whole of England.

Meanwhile, on 17th April, the British Journal of Diabetes published 6 papers detailing the findings of the Re:Mission study. Led by Professor Louisa Ells of Leeds Beckett University, this three-year research evaluated the qualitative aspects of the NHS TDR programme. The Re:Mission study demonstrated that the programme provided value for money and can work successfully to improve people’s diabetes control and weight loss.

The study showed that the programme has been life-changing for some participants, it was easy to incorporate into their lives and it helped them achieve their goals. According to the research, the aspiration of not requiring diabetes-related medication as well as potential for improvements to current health and fear of future poor health were viewed by participants as key-drivers for starting the programme.

Participants reported rapid improvements in their weight and blood glucose levels during the TDR phase and some reported significant levels of weight loss of up to 20% of starting body weight. Other reported outcome measures included feelings of increased energy, mobility, functional fitness and improved self-esteem.

Moreover, participants reported that using TDR gave them a sense of control over their energy consumption that they struggled to manage within their standard diet and some stated that they might continue using TDR products outside the programme specification for convenience and to sustain weight loss. By the end of the food reintroduction phase, 15 of the 43 participants were either actively using TDR products or expressed an intention to continue doing so.

Diabetes UK, a leading charity, estimates that more than five million people in the UK are living with diabetes, a disease that costs NHS £10 billion a year, which is about 10% of its entire budget. With its Type 2 Diabetes Path to Remission Programme, the NHS England has set the example for European public health authorities on how to help individuals with obesity and T2DM improve their health in a primary care setting as well as on how to reduce health-care expenditure related to these health conditions.

On 22nd May, from 11:00 to 12:00 BST, TDMR Europe will be hosting a webinar on “Diabetes remission after weight loss with Total Diet Replacement (TDR): 5-year evidence and feasibility of use in osteoarthritis” featuring key experts in the field to discuss the latest evidence regarding the efficacy of TDR in delivering the initial weight loss needed for T2DM remission as well as the sustainability and practicality of TDR-based programmes. The seminar will include guest speakers Professor Mike Lean, from Glasgow University, who co-directed the DiRECT trial,  as well as Professor Henning Bliddal from the Parker rheumatology Institute, Copenhagen. You can find out more and register here.

Aris Myriskos

TDMR Europe Secretariat

PR and Media Relations Office