Pragmatic management of low energy diets in people with Type 2 diabetes in primary care: a decision aid for clinicians

Significant weight loss at a level to achieve remission in the short‐term has been achieved through total dietary replacement or a low‐energy diets <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0001">1</a>-<a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0003">3</a>. These diets aim for an energy restriction to between 800 and 1600 kcal/day, and could achieve 15% weight loss in 8–12 weeks <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0004">4</a>. This is distinct from a very‐low‐energy diet of < 800 kcal/day <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0005">5</a>. As observed by Astbury <i>et al</i>. <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0002">2</a>, combinations of food, meals and meal replacement products are all effective at achieving a significant level of weight loss in this time. Analysis of the pragmatic intervention utilized in the Diabetes Remission Clinical Trial (DiRECT) indicates that it is a safe and cost‐effective strategy, and appears to result in sustained weight loss in some cases <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dme.14265?af=R#dme14265-bib-0006">6</a>.