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Weight Management 2019

Type 2 diabetes remission ‘empowers’ people


Alison Barnes

Senior Research Associate at Newcastle University

Diabetes diagnoses have more than doubled over the last 20 years, with more than 4.7 million people living with diabetes in the UK. 90% of these people have Type 2 diabetes, a condition which is linked with obesity and poor nutrition.

This has traditionally been seen as a life-long, irreversible condition. However, recent studies using low calories diets have led to a “transformative new understanding” of Type 2 diabetes among healthcare professionals. These studies, including DiRECT, have demonstrated that achieving sustained non-surgical remission of type 2 diabetes is possible.

Open discussions increase awareness

Alison Barnes, a Senior Research Associate at Newcastle University and Specialist Diabetes Dietitian who worked closely with Professor Roy Taylor on the DiRECT trial, said: “I think it’s important we discuss remission and consider how we do that effectively with patients in clinic. The concept of remission challenges some long-held beliefs, but we must all provide evidence-based care, and the first step to doing that is to understand the evidence.

“Guidelines only provide a few lines of information, a very brief summary. There’s a wealth of information behind those few lines, and I’d encourage anyone who sees people with type 2 diabetes in their practice to find out more.”    

The earlier in someone’s type 2 diabetes journey we start having remission conversations, the greater the chance of achieving it.

“Conversations about type 2 remission have completely transformed my practice. My clinic has felt like a much more positive place ever since I started having these discussions. Talking about remission transforms people’s view of this serious condition they have been diagnosed with, and so many become engaged and motivated to make a change when they hadn’t before. It offers hope – of recovering health, of reducing reliance on medications. These are very powerful motivators. Sometimes the conversation itself is enough for people to go and lose the weight themselves. But for most, having the right kind of support from their healthcare team makes a big difference.”

Act now rather than later

Despite the exciting research findings, Alison said it is important to exercise a “note of caution” and manage expectations, because remission can depend on how long a person has had type 2 diabetes for example, and it will not be possible for everyone. Knowing how to manage that possibility is also really important.

She added: “The earlier in someone’s type 2 diabetes journey we start having remission conversations, the greater the chance of achieving it. The weight loss and associated metabolic improvements can make an immediate difference to people’s quality of life, and also has huge implications for population health outcomes and healthcare costs in the future. The more we educate and empower people with diabetes and healthcare professionals, we might start seeing more and more people putting their type 2 diabetes into remission. I’d say that’s a pretty positive thing.”

New understanding of type 2 diabetes

Alison plans to summarise the findings of remission research studies using low calorie diets including DiRECT, explain the physiology of remission and outline recent guideline changes and work on defining remission criteria during a presentation at Diabetes Professional Care (DPC) in October.

She said, “The session will provide a comprehensive, but succinct, overview of this transformative new understanding of type 2 diabetes, which previously had always been thought of as a chronic, progressive condition with no turning back.”

Healthcare professionals can attend Alison’s session at the Diabetes Professional Care (DPC) conference, held on 29 & 30 October, for free by registering online.
The London-based, CPD-accredited conference will also feature sessions including Healthier You: NHS Diabetes Prevention Programme and NHS England Low Cal Diet Pilot.

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