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Saptarshi Bhattacharya, Sanjay Kalra, Lakshmi Nagendra

Very few trials in the history of medical science have altered the treatment landscape as profoundly as the UK Prospective Diabetes Study (UKPDS). Even 44 years after its inception, the trial and post-study follow-up findings continue to fascinate and enlighten the medical community. The study was conceived at a time when there was uncertainty about […]

Michael Lean, ADA 2018 – Latest Results of the DiRECT Study

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Published Online: Jul 5th 2018

Dr Michael Lean (Chair of Human Nutrition [Medicine], University of Glasgow, Glasgow, UK) reviews the Diabetes Remission Clinical Trial (DiRECT). Weight loss is the most important thing patients can do to reduce glycated hemoglobin, reduce/eliminate comorbidities, and eventually gain diabetes remission. The DiRECT trial, funded by Diabetes UK, has been set up to help patients lose weight without bariatric surgery, and in turn become non-diabetic. Post-hoc analyses of the DiRECT trial have shown that almost 50% of patients can achieve remission of diabetes through weight loss, but the question remains, how do we identify these patients? Results showed there was no difference in males and females, older patients performed better than their younger counterparts, and certain medications hindered weight loss. Finally, Dr Lean highlights one of the main focuses of ADA 2018, which is drivers of disease progression, being high lipids and high insulin – both of which are caused by weight gain.

Questions:
1. What was the background and rationale behind the Diabetes Remission Clinical Trial (DiRECT)? (0:14)
2. What were the findings of the post-hoc analysis presented at this meeting? (1:35)
3. What are the next steps in this area of research over the coming years? (3:08)
4. What are you highlights from this year’s ADA meeting? (4:15)

Filmed at the American Diabetes Association (ADA) Annual Meeting, June 2018

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