A University of Sydney research study
Finding a new way to manage type 2 diabetes.
References
- 1.Hocking SL, Markovic TP, Lee CMY, Picone TJ, Gudorf KE, Colagiuri S. Intensive lifestyle intervention for remission of early type 2 diabetes in primary care in Australia: DiRECT-Aus. Diabetes Care. 2024;47(1):66–70. View source
- 2.Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–551. View source
- 3.Type 2 diabetes remission is defined as a reduction of HbA1c to under 6.5% (48 mmol/mol) sustained for at least three months without glucose-lowering medication.
- 4.Riddle MC, Cefalu WT, Evans PH, et al. Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care. 2021;44(10):2438–2444. View source
What participation involves
- Follow the diet program as instructed
- Use the app to track your progress and view educational content
- Attend occasional telehealth appointments with the research team
- Provide four blood samples over twelve months (at no cost to you)
How the program works
The weight loss program runs for one year in three phases.
Phase 1: Total diet replacement
Replace your usual meals with nutritionally complete meal replacement shakes. The number of shakes per day (3 or 4) is based on your body weight.
Phase 2: Food reintroduction
Gradually introduce regular foods back into your diet. The app provides guidance to help you build eating habits that keep your weight stable.
Phase 3: Weight maintenance
Focus on keeping the weight off and building lasting habits around food and physical activity.
What is provided
There is no payment for taking part, but we'll provide the following for free:
Meal shakes
We'll provide all your meal replacement shakes. Worth approximately $400.
Pathology tests
We cover the cost of blood tests required to monitor your health, which can be done in a lab close to you.
Telehealth support
You'll have time to chat with the trial dietician over video call.
reMISSION app
You'll have full access to the reMISSION app for the duration of the program.
Possible benefits
We can't guarantee any particular outcome and results will vary between individuals. Possible benefits of taking part include:
- Diabetes remission
- Weight loss
- Improved blood sugar control
- Reduced reliance on diabetes medication
Who can take part
You may be eligible if you:
- Are 18 or older
- Live in New South Wales
- Have been diagnosed with type 2 diabetes within the past 6 years
- Are not currently treated with insulin
- Have access to a smartphone and a reliable internet connection
The research team
The study is led by researchers at the University of Sydney's Central Clinical School.
A/Prof Samantha Hocking
Chief Investigator
Dr Monica Liu
Clinical Trial Lead Dietitian
Ms Melissa Men
PhD Student & Research Assistant
Mrs Sharon Breen
Developer & Digital Content Designer
Interested in taking part?
Take a short eligibility quiz to find out if the study is right for you. It takes about a minute and doesn't commit you to anything.
Frequently asked questions
Frequently asked questions
Is it really free to take part?
Yes, there's no cost. The shakes for Phases 1 and 2, all required pathology tests, and access to the the app are all provided at no charge. You won't be reimbursed for your time.
I take insulin. Can I still take part?
No. People currently treated with insulin aren't eligible for this study. If you take other diabetes medications, such as metformin or an SGLT2 inhibitor, the research team will review those with you before you start.
I don't live in Sydney. Can I still take part?
Yes. You can participate if you live anywhere in Australia. The program is delivered virtually, so you don't need to travel to Sydney. You will need to visit a local pathology centre four times over the year. You also need to have access to a smart device (laptop, tablet or smartphone) to use the reMISSION app and attend telehealth appointsments with the research team.
Can I withdraw once I've started?
Yes. Taking part is voluntary and you can withdraw at any time, without having to give any reason.
What happens to my medication during the study?
The research team will review your oral diabetes and blood pressure medications before you begin. Some medications may be reduced or paused to reduce the risk of low blood sugar or low blood pressure during the diet phase. A/Prof Hocking supervises this throughout.
Risks and things to consider
Risks and things to consider
Medication review
If you take oral medication for type 2 diabetes or blood pressure, your medication may be reviewed and reduced or paused at the start of the program. This is to reduce the risk of your blood sugar or blood pressure dropping too low during Phase 1. A/Prof Samantha Hocking will supervise your medications throughout the study. You should continue to monitor your blood sugar as part of your usual care.
If your blood sugar rises above 12 mmol/L at any point, your medication will be restarted if it's safe to do so.
Pathology and blood collection
You may feel some discomfort when blood is drawn. Minor bruising at the collection site is possible and usually clears up within a day or two.
Pregnancy
A very low-energy diet is not recommended during pregnancy or breastfeeding. If there's any chance you could be pregnant at the start of the study, a urine pregnancy test will be needed before you begin. You'll need to use reliable contraception throughout the program.
Emotional wellbeing
Some people find it hard to talk about dietary habits or food-related topics. You're not required to answer any question you're not comfortable with, and you can stop any session at any time.