Media Spotlight: New NHS trial on diabetes reversal

Type 2 diabetes in a very common health condition in the UK, particularly among people who are overweight or obese. It is estimated to cost the health service £10 billion a year, and around one in ten prescriptions is for diabetes treatment. The current coronavirus pandemic has also put diabetes in the spotlight – it is thought that people with diabetes are twice as likely to die from Covid-19, and that around a third of Covid-19 deaths are people with diabetes.

It has always been thought that once you have been given a diagnosis of type 2 diabetes, that’s it for life. However, there is emerging evidence to suggest that diabetes could be reversed by following a very low calorie diet (VLCD). VLCDs (of which the Slim & Save plans are examples of) cause rapid weight loss by restricting carbohydrate intake to a level that induces ‘ketosis’ – a state where the body breaks down fat into ‘ketones’ to provide energy, causing rapid weight loss. Back in 2018, results from the DiRECT trial suggested there may be a role for using VLCDs as a first-line approach to weight loss, particularly upon diagnosis of type 2 diabetes. This resulted in plenty of media coverage. The BBC aired ‘The Big Crash Diet Experiment’ (which followed four volunteers who all lost significant weight over nine weeks on the diet, with one person losing 20% of their body weight, and putting their diabetes into remission) and ITV featured ‘Fast-Fix Diabetes’ (which followed five volunteers who all significantly reduced their blood sugar levels, with one person reversing their diabetes, after eight weeks on the diet).

The NHS has now enrolled 5000 people in a new trial, where patients are restricted to a diet of 800 kcal a day, using VLCD products like soups, shakes and bars (similar to those consumed on our Slim & Save plans). The trial aims to assess whether following a calorie restricted diet can reverse diabetes.

Key points about the new trial

  • It is a large trial, involving 5000 patients, all of whom have had a diagnosis of type 2 diabetes within the last six years
  • There are seven NHS sites across England taking part
  • The trial is split into two phases – phase one involves patients following an 800kcal restricted diet for three months
  • The second phase involves a healthy diet and exercise routine being reintroduced for the following nine months. This is being done through the support of ‘nutritionists’, who have received training from a specialist multi-disciplinary team (including dietitians)
  • Patients will be supported via virtual one-to-one sessions, group sessions and digital support

So… Can diabetes be reversed?

Research has shown us that type 2 diabetes can be put into ‘remission’, which is when blood sugar levels remain below the diabetic range and the person no longer needs to take medication. To be classed as ‘in remission’, the person should have normal blood sugar control and be free of medication for at least six months. Research also shows us that losing 15kg significantly increases your chances of remission, and doing this closer to the time of diagnosis also increases chances.

The term ‘reversal’ is not a particularly helpful term, as it implies that diabetes can be cured. If a person whose diabetes is in remission starts gaining weight again, or eating a poor diet, their diabetes is likely to come back.

This new trial will help to increase the evidence base for diabetes remission, and may lead to VLCDs being available on prescription in the future.

What does this all mean for me?

If you have been diagnosed with type 2 diabetes, and are currently following (or are considering starting) a Slim & Save programme, here are our main take-home points:

    • To see a mass trial like this being run by (and funded by) the NHS, provides confidence to people wondering if following a Slim & Save plan will have beneficial effects for them, both in terms of weight loss and also diabetes control – if positive results are seen from this trial, it’s likely that it would be rolled out further
    • If you are overweight or obese (BMI over 25) and have diabetes or another significant weight related health condition, a VLCD may be the best solution for you (especially if you have tried conventional diets in the past)
    • Always consult with your GP to check your suitability prior to starting a VLCD
    • It appears that to have the best chance of putting your diabetes into remission, you should lose weight (through following a VLCD) as soon as possible after diagnosis. Current evidence suggests that the longer you have had diabetes, the less likely you will be able put it into remission
    • Losing weight on Slim & Save may mean you need to reduce your diabetes treatment (medication or insulin). Don’t forget to regularly check your blood glucose control and seek advice from your GP or specialist nurse (check out our other article Considerations for people with diabetes.
    • Following a VLCD requires a huge amount of support – make sure you enlist support from family and friends, as well as making use of Slim & Save’s support team and forums to help you stay motivated and on track
    • Once you come off Slim & Save, it’s really important that you don’t just go back to your previous diet, as this will cause you to regain the weight you’ve lost. You will also need to increase your physical activity (exercise) levels to keep the weight off. Support and advice are also really important for this stage. Check out our weight maintenance plans and other articles on weight maintenance

Written by Annemarie Aburrow RD BSc (Hons) PGDip, Slim & Save Dietitian.

24 comments

  1. I have type 2 diabetes, also NAFLD now in fibrosis stage I do not drink alcohol and I’ve tried all diets nothing seems to work. 15 years ago before I was diabetic I lost 5 stone using lipotrim shakes I felt great but I’ve tried them and just can’t seem to do it again so I’m hoping that trying the simplicity 4 a day plan will help me I’m taking metformin and novamix insulin twice a day I’m going to keep my eye on my glucose levels and keep in contact with my gp to alter my insulin accordingly I really hope this works for me. Fingers crossed and good luck to all others who are trying these.

  2. I think this is a huge step in the right direction well done NHS England! Obesity is the scourge of modern Britain, and must cost the NHS millions each year. VLCD is not for everyone, but if it can put diabetes into Remission then why wouldn’t you give it a try!?!

  3. I’ve watched my mum for the past 29 years yoyo diet and now she’s suffering the consequences of carrying so much weight. My mum are her heaviest was 22st. I Watch her now struggle with mobility and various health concerns as a result of putting so much strain on her body. I’ve tried eatting a low calorie diets and it’s never worked. So I came to SnS and I find it very easy to stay in control of what I eat. I want to prevent diabetes and other health issues that come with being over weight and i agree with the whole article that with a vlcd you can reverse diabetes.

  4. It’s very refreshing to see that the NHS are willing to consider new treatments.

    Diet plans like Slim & Save are becoming more mainstream, which can only be a good thing.

    I’ll be keeping a keen eye on the outputs from the NHS trial. Fingers crossed that it is successful for the patients involved.

  5. I have a diagnosis of T2 and I have I had the results back from my three monthly Hb1c …it’s now 44 making me prediabetic…no longer officially T2. Anything over 48 and you’re T2. My fasting blood glucose has gone from 15 to 8 (which is still not normal but bloody good for me) It has dropped and negated my need for metformin while I’ve been on Slim and Save. I still have a long way to go but would be happy to privately submit my NHS results to slim and save when I’m at goal weight. Also, my cholesterol is down from 7 to 5.5. My inflammation markers are down from 12 to 6 and my last scan of my liver showed that my NAFL was reduced. I fall off the SNS wagon occasionally but I avoid sugar and keep treats low carb. I feel great and as I’ve said would be happy to share my results when I’m closer to my destination …nearer Christmas.

  6. I’m a newbie starting this tomorrow and news that this is being trialled is very encouraging and has spurred me on. I’ve lost 6 stone through about 4 different diets over the last year and a half and despairing I’ve not lost any over the last 6 months.
    So let’s hope, I have will power and I’m determined just hoping it suits me so I can loose another 5 stone to goal!

  7. What an absolutely great idea! We know it works, not sure why the NHS are only just grasping it to be honest? Yes the diet is hard, its mentally and physically challenging but its so worth it. The health benefits are immeasurable. I hope this means a dramatic reduction in diabetes in general for future generations

  8. At last is my initial response.
    For years VLCD diets have been protrayed in a negative light, which is why when embarking on a journey one has always had negative comments from friends/family members. With this trial running and all the publicity around it at last people will understand how beneficial a vcld is and realised it is safe and a healthy way of doing it and not a fad! It’s a pity it takes such measures but I for one am happy this type of weight loss plan is getting positive media representation. It’s like the rest of the world has been let in on our fabulous secret.

    It’s good to see that this is being trialled by the NHS and I ahsv every confidence that this will help a lot of people.

  9. I think this is brilliant and gives me confidence that this is a safe plan to follow I know it works but understand how drficult it is to stay focused they are really going to need the support but the results will save money for the NHS and more importantly have major health improvements, brilliant I’m all for it x

  10. I think this is a great idea. I work with young people with diabetes and when this came out in the news i was able to talk to them about this and also told them i was on the SnS plan and i have lost 13lbs so far. I was able to motive 2 of them to start the plan. And with the mindset that losing weight safely with SnS will help reverse their diabetes and they will also look and feel great. We do Monday weigh ins and so far they are both doing really well.

  11. Fantastic idea. I like that it’s being trialled with so many people results should speak for their selves as many of us following sns will tell you its definitely working xx

  12. As some of the writers above I have not got to the stage of type 2 diabetes even though my BMI did at one point have me as Morbidly obese. I have experienced another health benefit though and that is after years on blood pressure mediation I have now been taken off as my hypertension no longer exists . This is also thanks to Slim and Save VLCD.

  13. I was diagnosed with diabetes in 2016 and on medication. I was gaining weight and my diabetes was spiralling out of control. In 2018 I decided to go on a vlcd and within 3 months I had completely reversed my diabetes, I wasn’t even pre-diabetic. 2 years in and I am in remission even through I have gain a little weight.

  14. Completely agree with all of the above. Its clear VLCDs are proven to help not only in reversing type 2 diabetes but we can benefit from many other health issues too. Im a delivery driver and can get in and out the van much better since I started slim and save a couple of months ago. My hips hurt less and don’t feel as out of breath as I used to.

  15. I heard about the NHS trial a week ago, enquired, but unfortunately its not available in my area as yet. I did a VLCD 20 years ago and lost over 8 stone, brilliant! One of the greatest successes of my life! I put all the weight back on over the years though, and got Diabetes type 2 a couple of years ago. The NHS getting involved in this is a brilliant idea! It works! No its not easy and takes commitment, motivation, determination and support – something I’ve lacked for some years. However just this news has effectively given a measure of support to VLCDs – and given me the determination to do it again – but with Slim & Save this time! Today is my Day 1 – and with the support package I know I stand an excellent chance of success! I hope the NHS will offer support similar to yours to help ensure a successful trial. Their success will serve to validate the role of VLCDs in weight loss, help people avoid type 2 Diabetes and I do hope play a key role in its reversal!

  16. Finally, NHS England is going the way researchers and medical experts like Michael Mosley has been telling us for a few years that;
    1. Type 2 DM can be reversed.
    2. VLCD trials for 12 weeks have been succesully tried and DM reversed
    3. Win win for the ones on the diet VCDL 12 werk on prescription or not (only ENG on prescription) – lose weight, reverse diabetes, enjoy health.
    12 week of VCDL is a sacrifice worth making – unfortunately in Scotland our NHS is still quite nervous to accept VCDL or trials on several obese/tupe2 DM.
    All the best to all on it!

  17. I have been type 2 for 8yrs , have found it difficult to keep my blood sugars under control.
    Have tried many other diets but nothing worked .
    I started Slim & save about 4yrs ago on and off and it works my blood sugars dropped ,my Hb1C dropped my diabetic nurse was happy with the results even though she was not 100% happy with the VLCD.
    I work for the NHS and all my nurse colleagues would say its dangerous, it doesn’t work etc , I am so happy now that the NHS has started this programme to show the doubters that it is ok and safe to use .
    I will be starting again and prove to everyone slim and save does work

  18. I have been fortunate not to end up with type 2 diabetes despite becoming morbidly obese. This is down to the luck of genetics as much as anything but I know how close I could have come if the cards fell differently.

    Having the health service acknowledge the benefits of following a plan such as this is fantastic. Knowing this should now be without the usual ‘it’s bad for you!’ ‘you’ll put it all back on!’ etc comments as it’s now great progress.

    I don’t live in England so wouldn’t qualify even if I did fit the criteria but good luck to the thousands of people this change in thought can now bring

    I love SNS and after 6 months am now nearly 4 stone lighter, much healthier and can see the end goal – even if I’m not even half way done yet.

  19. Having suffered with gestational diabetes during all four of my pregnancies, I was warned that I have a very high risk of developing type 2 diabetes later in life. In fact, such was my insulin dependency during my last pregnancy, the diabetes nurse said ‘see you in clinic’ after I’d had my daughter. Much to my surprise, the diabetes went away as soon as my daughter was born, I was now pre-diabetic, but that nurses words stayed with me.
    I realised I needed to lose weight, or risk a life of insulin injections as had been the case during my pregnancies.
    I joined a slimming club but found it frustrating that I would try really hard to stick to the eating plan, and excerised regularly, but I’d only lose 1/2lb a week here and there. I gave up so many times, feeling deflated. I’d failed again at a diet. I was destined to be obese and T2 diabetic. I accepted my fate.

    Then, someone told me about VLCD and explained how ketosis works. ‘it’s been shown to reverse T2 diabetes’ she said.
    After a Google and Internet search, I discovered SNS. The website was clear, informative, and easy to navigate. I ended up ordering a taster box and a few days later tried my first pack. I managed my first day of packs and surprisingly found I wasn’t hungry, a key issue in failing on other slimming plans.
    In my first week, I lost 9lbs, to say I was delighted is an understatement! The weeks passed and I’d lost 2st 2lbs and during my last yearly diabetes check-up, the nurse told me I wasn’t even pre-diabetic anymore! I’m delighted and feel healthier than I have ever done during my adult life. I’m approaching 50 years old and hoping to keep fit and well throughout menopause and keeping T2 diabetes away.
    SnS hasn’t just changed my life, I’m pretty sure it’s saved my life!

    The fact the NHS is supporting people on VLCD to improve their health is such a good idea, and will undoubtedly transform and save lives.

  20. It’s so exciting that this is being trialled on such a large scale. I have personally witnessed the power of VLCD combined with low carb eating. I have tried many diets for many years with very little success and I was beginning to think that my PCOS meant I had to resign myself to being overweight for the rest of my life. The world needs to know the secret,

  21. I have been type 2 for 4yrs and also have pcos so weight is a big issue. I’ve tried many diets and always find vlcd works, I’m yet to try Slim n Save. The nhs vlcd is exciting, unfortunately not in my area yet. Really keen to get onto a vlcd again.

  22. I was pre-diabetic, and I have been on slim & save for 5 weeks now and lost 24lb already and my blood sugar is 4.7mmol/l it’s well within the normal range now
    I have never lost weight like this before, as I have an underactive thyroid, and on tamoxifen, I was struggling to lose weight, one pound off then back on again for three months was going nowhere.
    It’s a good thing the NHS is doing, as it will save them money give people a better quality life as there are people that can afford the extra cost. It will show people it can be done and VLCD works.
    All I can say to slim & save admin is wow!!! Thank you.

  23. I was pre diabetic in Feb 2019 2 weeks before my 50th birthday ! It was such a shock at first but when I really thought about it the way I was eating and guzzling bottles of Lucozade and fizzy pop it wasn’t that much of a surprise really….
    I weighed approx 16st 10…enough I thought !
    I went on holiday for my 50th birthday I ate all low carb while there and the minute I got back I ordered my slim and save shakes as I knew it was proven to reverse diabetes.

    Best thing I ever had done I went from a size 20/22 to a size 8 approx 10 month later , I’m at goal and have been maintaining now for nearly a year and still use slim and save for maintenance, it’s been a god send I would reccomend it to anyone who is struggling with their weight
    I am very happy the NHS is approving a VLCD I believe the cases of diabetes will dramatically fall through this intervention

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