Remission of Type 2 Diabetes with a Primary Care–Based Weight-Loss Program

Bariatric surgery often leads to lasting remission of type 2 diabetes. Can long-term remission of type 2 diabetes be achieved in primary care practices with nonsurgical weight-loss programs?

In a cluster-randomized trial in the U.K., researchers assigned 149 patients from 23 primary care practices to intensive weight-loss intervention and 149 patients from 26 control practices to usual care. Patients had type 2 diabetes for as long as 6 years, body-mass indexes of 27 to 45 kg/m², and glycosylated hemoglobin (HbA_1c) levels <12%. The intervention, delivered by local nurses or dietitians after 8 hours of training, consisted of suspension of all antidiabetic and antihypertensive medications and total diet replacement with a low-energy formula di…