Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial

Lean, Michael E. J.; Leslie, W. S.; Barnes, Alison C.; Brosnahan, Naomi; Thom, George; McCombie, Louise; Peters, Carl; Zhyzhneuskaya, Sviatlana; Al‐Mrabeh, Ahmad; Hollingsworth, Kieren G.; Rodrigues, Angela; Rehackova, Lucia; Adamson, Ashley J.; Sniehotta, Falko F; Mathers, John C.; Ross, H. M.; McIlvenna, Yvonne; Stefanetti, Renae J.; Trenell, Michael I.; Welsh, Paul; Kean, Sharon; Ford, Ian; McConnachie, Alex; Sattar, Naveed; Taylor, Roy

doi:10.1016/s0140-6736(17)33102-1

Cited by 1,371 publications

(1,352 citation statements)

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“…Lifestyle change, including weight loss, improves HbA 1c concentration and other cardiovascular risk factors in people with Type 2 diabetes 1, 2, 3, and can achieve remission to a non‐diabetic state, with remission closely related to the degree of weight loss 3. As well as weight loss, increasing physical activity is a target of such interventions, but success in changing activity behaviour is often limited 1, 2 and any changes are rarely maintained at initial levels 3.…”

Section: Introductionmentioning

confidence: 99%

“…As well as weight loss, increasing physical activity is a target of such interventions, but success in changing activity behaviour is often limited 1, 2 and any changes are rarely maintained at initial levels 3. Physical activity has independent benefits for health and is important in the maintenance of weight loss; there is a need, therefore, to develop acceptable and sustainable physical activity interventions for people with Type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

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Potential of electric bicycles to improve the health of people with Type 2 diabetes: a feasibility study

et al. 2018

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AimTo explore in a feasibility study whether ‘e‐cycling’ was acceptable to, and could potentially improve the health of, people with Type 2 diabetes.MethodsTwenty people with Type 2 diabetes were recruited and provided with an electric bicycle for 20 weeks. Participants completed a submaximal fitness test at baseline and follow‐up to measure predicted maximal aerobic power, and semi‐structured interviews were conducted to assess the acceptability of using an electric bicycle. Participants wore a heart rate monitor and a Global Positioning System (GPS) receiver in the first week of electric bicycle use to measure their heart‐rate during e‐cycling.ResultsEighteen participants completed the study, cycling a median (interquartile range) of 21.4 (5.5–37.7) km per week. Predicted maximal aerobic power increased by 10.9%. Heart rate during electric bicycle journeys was 74.7% of maximum, compared with 64.3% of maximum when walking. Participants used the electric bicycles for commuting, shopping and recreation, and expressed how the electric bicycle helped them to overcome barriers to active travel/cycling, such as hills. Fourteen participants purchased an electric bicycle on study completion.ConclusionsThere was evidence that e‐cycling was acceptable, could increase fitness and elicited a heart rate that may lead to improvements in cardiometabolic risk factors in this population. Electric bicycles have potential as a health‐improving intervention in people with Type 2 diabetes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Potential of electric bicycles to improve the health of people with Type 2 diabetes: a feasibility study

et al. 2018

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“…December 2017 saw release of the 12-month primary outcome results, 3 showing impressive results. Weight loss of 15kg or more was achieved by 24% in the intervention group compared with none in the usual care group.…”

Section: What Did the Trial Find?mentioning

confidence: 99%

Is weight loss the future of type 2 diabetes treatment?

Dowden¹

2018

Prescriber

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Achieving remission from type 2 diabetes was once only thought to be realistic for patients undergoing bariatric surgery. But this view is changing with early publication of results from the Diabetes Remission Clinical Trial (DiRECT) based in Scotland and Tyneside, which has found success through a strict low‐calorie diet. This article discusses the implications of the study for the future of diabetes treatment.

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“…New studies have demonstrated remission from a diabetic state for almost half of a patient population solely on the basis of increased activity and weight loss in a primary care setting [3]. A recent study showed that 96% of a representative sample of 1004 Danes between 40 and 60 years prefer lifestyle change to medication [4].…”

Section: Introductionmentioning

confidence: 99%

Determinants of Successful eHealth Coaching for Consumer Lifestyle Changes: Qualitative Interview Study Among Health Care Professionals (Preprint)

Brandt¹,

Søgaard²,

Clemensen³

et al. 2018

Preprint

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Background: Success with lifestyle change through e-health has been demonstrated in numerous studies, but evidence on how to maintain the effect long-term is more variable. A recent study indicates that 12 months weight loss can be achieved in a primary care setting with almost half of patients achieved remission to a non-diabetic state and off anti-diabetic drugs. The effect of collaborative e-health in promoting lifestyle changes depends on effective and skilled healthcare professionals. How healthcare professionals perceive delivering asynchronous e-health coaching and which determinants are important to deliver successful long-term lifestyle coaching have only been briefly explored and needs to be explored.

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Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial

Abstract: Diabetes UK.

Cited by 1,371 publications

References 31 publications

Potential of electric bicycles to improve the health of people with Type 2 diabetes: a feasibility study

Potential of electric bicycles to improve the health of people with Type 2 diabetes: a feasibility study

Is weight loss the future of type 2 diabetes treatment?

Determinants of Successful eHealth Coaching for Consumer Lifestyle Changes: Qualitative Interview Study Among Health Care Professionals (Preprint)

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