reMISSION
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The University of Sydney

A University of Sydney research study

Finding a new way to manage prediabetes and type 2 diabetes.

While type 2 diabetes has been considered a non-reversible and progressive condition, consistent research 1,2 now shows that remission (that is, achieving normal blood glucose regulation) may be possible3,4 through low-energy diet and weight loss.

Our team has developed a new app called reMISSION as a convenient and cost-effective online tool to support people with prediabetes or type 2 diabetes to complete a 12-month long structured weight loss program.

This study aims to find out if the reMISSION app is an effective intervention for prediabetes and type 2 diabetes and achieves similar benefits when compared to similar in-person programs delivered under close medical supervision.

If you were diagnosed with prediabetes or type 2 diabetes (not currently on insulin), you may be eligible to take part.

Check your eligibility
References
  1. 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. 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. 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. 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 (meal replacement shakes provided at no cost)
  • Use the app to track your progress and view educational content
  • Attend occasional telehealth appointments and check in with the research team
  • Provide four blood samples over twelve months (at no cost)

How the program works

The weight loss program runs for one year in three phases.

1
Three meal replacement shakes — vanilla, strawberry and chocolate — beside their powder.
12 weeksWeeks 0–12

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.

2
A woman checking the reMISSION app while grocery shopping.
6 weeksWeeks 13–18

Phase 2: Food reintroduction

Gradually introduce regular foods and transition to a low-fat diet. The app provides guidance to help you build eating habits that keep your weight stable.

3
A family walking together along a tree-lined path in the afternoon light.
34 weeksWeeks 19–52

Phase 3: Weight maintenance

Focus on maintaining your weight loss and building lasting habits around food and exercise.

What is provided

There is no payment for taking part, but we'll provide the following for free:

Meal shakes

We'll provide your meal replacement shakes. Worth approximately $400.

Pathology tests

We cover the cost of blood tests required to monitor your health during the program, 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 may vary between individuals. Possible benefits of taking part include:

  • Diabetes remission
  • Improved blood glucose control
  • Weight loss
  • Reduced reliance on diabetes medication

Who can take part

You may be eligible if you:

  • Are aged between 18 and 65
  • Live in New South Wales, Australia
  • Have been diagnosed with prediabetes or type 2 diabetes within the past 6 years
  • Are not currently treated with insulin
  • Have access to a smart device 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 questionnaire to find out if the study is right for you. It takes about a minute and doesn't commit you to anything.

Check your eligibility

Frequently asked questions

Is it really free to take part?

Yes, there's no cost to you for participation. The shakes for Phases 1 and 2, all required pathology tests, and access to 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 NSW, 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 appointments 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 a 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. This will be closely monitored by the research team.

Risks and things to consider

Every effort will be made to make sure you feel comfortable and to maintain your privacy and confidentiality.

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. 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 reviewed and 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

If you are a woman of childbearing age, a very-low-energy total meal replacement diet is not recommended during pregnancy or while breastfeeding. Please inform the study team if there's any possibility that you are pregnant or planning to become pregnant.

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 a session at any time or withdraw from the study without giving a reason.