Lean et al. — Diabetes Remission Clinical Trial¶

One-paragraph summary¶

Primary-care practices delivered total diet replacement, food reintroduction and maintenance support to selected people with relatively short-duration T2D. At one year 46% were in remission versus 4% in control; remission rose from 7% with 0–5 kg loss to 86% with ≥15 kg loss (PMID 29221645).

Key findings¶

Demonstrated medication-free remission outside surgery.
Established a steep weight-loss dose response.
Remission declined to 36% at two years and 13% in the five-year extension group (PMID 30852132; PMID 38423026).

Limitations¶

Open-label cluster design and selected early-disease population.
Long-term attrition and weight regain constrain durability.

Why it matters¶

It changed the clinical narrative from inevitable progression to conditional reversibility.

Cited by wiki pages¶

Biomarkers
Glycaemic management and legacy trials
Guidelines
Metabolic surgery
Overview
Pathophysiology and subtypes
Patient experience and advocacy
Prevention
Remission and weight management
Youth-onset T2D