Pragmatic management of low energy diets in people with Type 2 diabetes in primary care: a decision aid for clinicians

Significant weight loss at a level to achieve remission in the short‐term has been achieved through total dietary replacement or a low‐energy diets 1-3. These diets aim for an energy restriction to between 800 and 1600 kcal/day, and could achieve 15% weight loss in 8–12 weeks 4. This is distinct from a very‐low‐energy diet of < 800 kcal/day 5. As observed by Astbury et al. 2, combinations of food, meals and meal replacement products are all effective at achieving a significant level of weight loss in this time. Analysis of the pragmatic intervention utilized in the Diabetes Remission Clinical Trial (DiRECT) indicates that it is a safe and cost‐effective strategy, and appears to result in sustained weight loss in some cases 6.