Part 1: Can Type 2 Diabetes Go Into Remission?

For years, Type 2 Diabetes (T2D) was thought to be a lifelong, progressive condition. But research over the past decade has completely changed that narrative. It’s now clear: remission is possible.

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What Does "Remission" Mean?

Remission doesn’t mean diabetes is cured. It means your blood glucose levels have returned to below the diabetes threshold without the need for diabetes medications, typically for at least 3 months. International consensus, including guidance from Diabetes UK, NICE, and the American Diabetes Association, defines remission as achieving an HbA1c of less than 6.5% (48 mmol/mol) without diabetes medication.

This is a clinical milestone, not a guarantee that the disease is gone for good. Many people who achieve remission may eventually see their blood sugars creep up again, especially if weight is regained or unhealthy habits return. But for now, remission offers a powerful, hopeful goal.

Why Early Diagnosis and Intervention Matter

Timing is everything. Evidence shows that people diagnosed within the last 6 years are much more likely to achieve remission, especially if they lose significant weight soon after diagnosis. The earlier the intervention, the better the chances of restoring normal insulin function and reducing damage to insulin-producing cells in the pancreas.

Early action can also reduce or even eliminate the need for medications and prevent complications such as nerve damage, kidney disease, or vision problems.

The Critical Role of Weight Loss

So, what’s the secret to remission? According to the latest science, weight loss.

A recent meta-analysis by Kanbour et al. (2025) of 22 trials found that weight loss is the single strongest predictor of remission. People who lost 15% or more of their body weight had the highest remission rates, as high as 86% in some studies. Importantly, the research shows that there is a threshold effect: those who lost less than 10% rarely achieved remission.

Why is weight loss so effective? Because excess fat, especially around the liver and pancreas, drives insulin resistance and disrupts insulin production. Losing weight helps reverse this process, restoring the body’s ability to manage blood glucose.

The UK Approach: Soups, Shakes, and Support

The UK has led the way globally in implementing remission-focused programmes into primary care. Inspired by the landmark DiRECT trial, which used a very-low-calorie total diet replacement plan, NHS England launched the “Soups and Shakes” pilot in 2020, now rolled out nationally.

The programme involves: 12 weeks of total diet replacement (~850 kcal/day). Followed by gradual food reintroduction and ongoing behavioural support and weight maintenance coaching.

Participants in the DiRECT trial who lost more than 15kg had a remission rate of over 80%. Even those who lost between 10–15kg had significant remission rates. Early real-world NHS results are promising, echoing these outcomes.

Crucially, the programme targets people early in their diagnosis (less than 6 years) and with a BMI of 27 or higher. It’s delivered through GP practices and is now part of routine NHS care in many regions.

Is Remission a Cure?

Short answer: No. Remission means that diabetes is under control without medication, but the underlying risk remains. If weight is regained, or if healthy habits are not maintained, blood sugars can rise again.

Think of remission as putting the condition into hibernation, not erasing it. Ongoing monitoring and lifestyle support are essential, even after remission is achieved.

But make no mistake: remission is a game-changer. It empowers people with T2D to take control of their health and possibly turn back the clock on their condition.