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Research project Substantial weight loss and remission of type 2 diabetes can be achieved through calorie restriction and are recommended in national and international guidelines. Long-term weight reduction is challenging, which limits use in routine care. eHealth may offer a more effective and less time-consuming alternative to standard follow-up for patients and healthcare providers.
In the eHealth DIabetes Remission Trial (eDIT), individuals with type 2 diabetes follow a total diet replacement regimen (900 kcal/day) with the aim of achieving approximately 15 kg weight loss and diabetes remission. The study compares both effectiveness and cost-effectiveness between two randomized groups: one receiving all contact with the study team through eHealth, and the other meeting the study staff in person.
Edgar Sjölund Diabetes Foundation
Anna Tellström, dietitian, Region Västerbotten
Claudia Schien, research nurse, Region Västerbotten
Jens Huul Holst, University of Copenhagen
Andreas Stomby, Linköping University
A recent UK study demonstrated that remission of type 2 diabetes is achievable through calorie restriction. In this study, individuals with type 2 diabetes followed a total diet replacement regimen of 850 kcal/day for three months, and after one year, 46% achieved diabetes remission. The accompanying health economic evaluation showed that remission through total diet replacement becomes cost-saving after 5–6 years, despite face-to-face consultations every 2–4 weeks during the two-year study period. Based on these findings, calorie restriction aiming for approximately 15 kg weight loss and diabetes remission is now strongly recommended in national and international treatment guidelines.
However, such frequent face-to-face visits are not feasible within routine clinical care in Sweden. As a result, calorie-restriction–based diabetes remission is not currently offered as a therapeutic option for patients with type 2 diabetes. To address this gap, we have developed a dedicated eHealth programme for the eHealth DIabetes Remission Trial (eDIT), designed to support patients in achieving diabetes remission through calorie restriction in a cost-effective manner. Our primary hypothesis is that the eHealth-based approach is non-inferior to face-to-face consultations regarding diabetes remission. A health economic evaluation will compare the cost-effectiveness of the two study arms.
To better understand the mechanisms underlying diabetes remission, we investigate several physiological domains, including resting metabolic rate, insulin sensitivity, insulin secretion, glucagon sensitivity, amino acid tolerance, postprandial incretin responses, lung function, and adipose tissue function and secretory capacity.
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