Within-trial cost and 1-year cost-effectiveness of the DiRECT/Counterweight-plus weight-management programme to achieve remission of type 2 diabetes
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Remission of type 2 diabetes has become accepted as an achievable management goal, with internationally agreed criteria.
“Remission of type 2 diabetes has become accepted as an achievable management goal, with internationally agreed criteria. 10”
From 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study (2024) · cites this paper as [10]
The paper’s main text reports that 46% of DiRECT intervention participants achieved remission at one year, calls remission a target for diabetes care, and argues that care budgets should support attempts to achieve it (page not specified in our copy). This supports remission as an achievable management goal, but the paper does not say that its criteria are internationally agreed. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBariatric surgery is expensive and incurs risks of long-term problems, such as post-prandial hypoglycaemia, hypovolaemic dumping syndrome and micronutrient deficiencies that restrict acceptability.
“However, it is expensive and incurs risks of long-term problems, such as post-prandial hypoglycaemia, hypovolaemic dumping syndrome and micronutrient deficiencies that restrict acceptability. 24,25”
From Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial (2019) · cites this paper as [24]
The paper’s introductory discussion (page unavailable) says bariatric surgery has complications and reaches only 1% of eligible people. It does not say surgery is expensive, identify the listed long-term complications, or attribute its limited reach to those problems restricting acceptability. (LLM, conf=0.86)
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Cites
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Lean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K. G., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(17)33102-1 · Cited by 2,095 · see citing works
Self-citationExcess Mortality among Persons with Type 2 Diabetes
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Association of an intensive lifestyle intervention with remission of type 2 diabetes
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Obesity, weight loss and prognosis in type 2 diabetes
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Self-citationThe Diabetes Remission Clinical Trial (DiRECT): protocol for a cluster randomised trial
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Self-citationImpact of diabetes mellitus on life expectancy and health-adjusted life expectancy in Canada
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Lean, M. E. J., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K. G., et al. (2019) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(19)30068-3 · Cited by 981 · see citing works
“The 12-month intervention cost is under half of the average annual UK healthcare cost of a person with type 2 diabetes.(23) These considerations, and the fact that DiRECT included a high proportion of participants from more socially deprived backgrounds 15 (unlike many other programs), all imply that the intervention…”
BackgroundSelf-citationLean, M. E., Leslie, W. S., Barnes, A. C., Brosnahan, N., Thom, G., McCombie, L., Kelly, T., Irvine, K., Peters, C., Zhyzhneuskaya, S., et al. (2024) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(23)00385-6 · Cited by 186 · see citing works
Self-citationXin, Y., Davies, A., Briggs, A., McCombie, L., Messow, C. M., Grieve, E., Leslie, W. S., Taylor, R., & Lean, M. E. J. (2020) · Diabetologia · doi:10.1007/s00125-020-05224-2 · Cited by 52 · see citing works
Self-citationRemission of Type 2 Diabetes with Very Low-Calorie Diets—A Narrative Review
Juray, S., Axen, K. V., & Trasino, S. E. (2021) · Nutrients · doi:10.3390/nu13062086 · Cited by 45 · see citing works
- Authors
- Xin, Y., Davies, A., McCombie, L., Briggs, A., Messow, C.-M., Grieve, E., Leslie, W. S., Taylor, R., & Lean, M. E. J.
- Affiliations
- University of Glasgow (GB)
- Newcastle University (GB)
- Corresponding author
- Lean, Michael E J
- ORCID
- Venue
- The Lancet Diabetes & Endocrinology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 7
- Issue
- 3
- Pages
- 169-172
- ISSN
- 2213-8587 (ISSN-L)
- PMC
- PMC6383752
- OpenAlex
- W2906199487
- Cited by
- 32
- References
- 15
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 1
- FWCI
- 6.08
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The Lancet Diabetes & Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Funders
- Diabetes UK as a Strategic Research Initiative (award number 13/0004691)
- Project Grant from Diabetes UK (award number 17/0005695)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, diabetes remission, weight management, DIRECT, cost-effectiveness, health care costs, obesity, bariatric surgery, lifestyle intervention, disability-adjusted life years, quality-adjusted life years, cost per quality-adjusted life year
- MeSH terms
- Cost-Benefit Analysis, Diabetes Mellitus, Type 2, United Kingdom, Humans, Primary Health Care, Remission Induction, State Medicine, Randomized Controlled Trials as Topic, Weight Reduction Programs
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