As rates of type 2 diabetes soar, and the disease affects younger and younger patients, British doctors will begin a staged rollout of a trial prescribing a liquid diet of four daily servings of “fat-free shakes and soup.” The prescribed drinks, intended to be the only food consumed, will provide patients with just over 800 calories per day. Participants will follow the liquid diet for up to 5 months, and then carefully transition back to real food.
This approach showed promise in the DiRECT trial, published in The Lancet last December. DiRECT was a well-designed trial, randomized by physician practice, and showed 46% of patients treated maintained remission from diabetes at 1 year, versus just 4% of control patients receiving the standard of care.
It is terrific to see physicians and health systems treating type 2 diabetes as a reversible condition rather than a progressive, chronic disease. However, remission with this approach is highly dependent on maintaining weight loss. Over the long term, maintaining weight loss by restricting calories has a very poor track record. And just about nobody wants to be on a liquid diet for life.