Type 2 Diabetes Remission

The Diabetes Remission team, based in the Directorate of Public Health, includes dietitians, psychologists, a medical doctor and administrative support staff. This service is part of a broader effort to prevent and intervene early in Type 2 diabetes.
 

The Diabetes Remission Programme is a structured weight management intervention with a target weight loss of 15kg. It combines nutrition education, medical monitoring and psychological support, delivered primarily in a group setting, with sessions usually held remotely. For the first 12 weeks, participants receive a FREE 12 week Total Diet Replacement, consisting of nutritionally complete shakes and soups. This provides 800-900 calories daily to replace all regular food. Medications for diabetes and blood pressure are usually stopped on day one of the intervention and then monitored at regular intervals.

People are eligible to join the programme if they meet the following criteria:

• Type 2 Diabetes diagnosed in the past 3 years.
• HbA1c of ≥48 mmol/mol (or ≥43 mmol/mol if taking diabetes medication)
• Aged 18-65 years oldMotivated to lose weight, achieve remission, are comfortable attending both in-person and remote group meetings, and can commit to a 12-week low calorie diet using meal replacements.

There is no specific lower (or upper) body mass index (BMI) required to join the programme 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.

This programme may not be suitable if an individual has:

• Severe or unstable heart failure
• Had a heart attack or stroke within previous 3 months
• Undergoing intensive cancer treatment
• Severe renal failure (eGFR <30 mls/min)
• Porphyria
• Is pregnant or considering pregnancy in next 6 months, or breastfeeding
• A severe and untreated mental health condition that would prevent successful engagement with the programme
• Drug and/or alcohol dependence that would prevent successful engagement with the programme
• Severe, unsupported learning disabilities or learning difficulties that would prevent successful engagement with the programme
• A current eating disorder

Please note, 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.

People should self-refer to the remission programme through our Type2Tayside website.

While self-referral is preferred, we also accept referrals via email at tay.diabetesprevention@nhs.scot or by letter to the Diabetes Remission team, Public Health Directorate, Kings Cross Hospital.

For individuals seeking more information on Type 2 diabetes remission, the following resources may be useful:

• NHS Scotland’s ‘My Diabetes My Way’ website.
• Diabetes UK diabetes remission website

As an alternative to the Type 2 Diabetes remission programme, people 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.

A step-by-step guide on initiating brief conversations about weight management with adults can be accessed here:  Let’s Talk About Weight.

Dr George Thom
Diabetes Prevention and Remission Programme Manager
george.thom2@nhs.scot