Diabetes Remission

Who we are

The Directorate of Public Health partners with the Tayside Adult Weight Management Service to deliver interventions for Type 2 diabetes remission. This is a key part of a broader programme focussed on the prevention, early detection and early intervention of Type 2 diabetes.
The Type 2 diabetes remission programme is a 12-month weight management intervention with a target weight loss of 15kg. The programme combines nutrition education, medical monitoring and psychological support. It is delivered in a group setting and led by Specialist Dietitians and Health Psychologists. Participants receive a FREE 12 week “Total Diet Replacement”, which is a nutritionally balanced low calorie diet of shakes and soups that replaces all regular foods to support optimal weight loss. About half of the participants who complete the programme achieve Type 2 diabetes remission, defined as having a HbA1c below 48 mmol/mol and no longer requiring diabetes medications.

Who to Refer

People with Type 2 Diabetes diagnosed in the past 3 years.
HbA1c of ≥48 mmol/mol (or ≥43 mmol/mol if taking diabetes medication)
Age range: 18-65 years
There is no specific lower (or upper) body mass index (BMI) limit as weight loss is appropriate even when BMI falls within the ‘healthy range’ (i.e. BMI<25 kg/m2). However, when Type 2 diabetes is diagnosed at a relatively low BMI, clinicians should carefully assess for monogenic or Type 1 diabetes.
People who are motivated to lose weight, achieve remission, comfortable attending both in-person and remote group meetings, and can commit to a 12-week low calorie diet using meal replacements.

Who not to Refer

Referrals will be assessed on an individual basis, however key exclusion criteria are listed below:

Severe or unstable heart failure
Myocardial infarction or stroke within previous 3 months
Undergoing intensive cancer treatment
Severe renal failure (eGFR <30 mls/min)
Porphyria
Pregnant or considering pregnancy in next 6 months, or breastfeeding
Severe and untreated mental health condition
Current bulimia nervosa
Drug and/or alcohol dependence that would impair ability to adhere to the programme
Severe, unsupported learning disabilities or learning difficulties which would impair ability to adhere to the programme

NB. Meal replacements may contain gluten due to cross-contamination, and the range of options is restricted for people with milk/lactose intolerance, or following a vegan diet.

How to Refer

Refer via SCI-Gateway to the Tayside Adult Weight Management Service
The referral should specifically request the Type 2 Diabetes Remission Programme and include the following information:
- Recent HbA1c, weight (kg), height and BMI
- Medical history
- Any language or communication needs.

More information on the programme is available here: Type 2 Diabetes Remission Pathway.

Alternatives to Referral

Individuals who would like more information on Type 2 diabetes remission may find the following resources useful:
- NHS Scotland’s ‘My Diabetes My Way’ website.
- Diabetes UK website type-2-reversal .
As an alternative to the Type 2 Diabetes remission programme, people who have been diagnosed with Type 2 diabetes in the last 3 years can self-refer to the Oviva Diabetes Support programme. This provides structured education and 12 weeks health coaching via Smartphone app.

Useful resources

For patients, an information leaflet is available on Staffnet: Type 2 diabetes remission programme
For healthcare professionals, a step-by-step guide on initiating brief conversations about weight management with adults can be accessed here: Let’s Talk About Weight.

Programme Contact

Dr George Thom
Programme Manager for Prevention, Early Detection and Early Intervention of Type 2 Diabetes george.thom2@nhs.scot