Executive summary
* Two trials – the DROPLET trial published in 2017 and the DiRECT trial published in 2018 – demonstrated that type 2 diabetes (T2D) could be put into remission with a very low-calorie (meal replacement soups & shakes) diet.
* DiRECT claimed to have provided the first evidence of a diet/lifestyle intervention putting T2D into remission. This was not true. This note presents the evidence preceding the DiRECT trial for low-calorie and low-carb dietary interventions.
* Since 2019, the UK National Health Service (NHS) has been offering a ‘soups & shakes’ programme to adults recently diagnosed with T2D.
* This week’s note is about a paper published in August 2024, which reviewed the outcomes from 7,540 people who started this soups & shakes programme before the end of 2022.
* Depending on the participant group chosen, it could be claimed that 2{e60f258f32f4d0090826105a8a8e4487cca35cebb3251bd7e4de0ff6f7e40497} or 32{e60f258f32f4d0090826105a8a8e4487cca35cebb3251bd7e4de0ff6f7e40497} of people achieved remission of T2D.
* I’ve reviewed DiRECT extensively in previous Monday notes and this note shares findings of the carb content of the soups & shakes programme. Very low calorie intake is inevitably low carb. The maintenance intake on this programme can be even lower carb still.
* I close by explaining the importance of the soups & shakes programme and why the low carb community should embrace it.
