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The secret to long term type 2 diabetes remission

The secret to long term type 2 diabetes remission


Evidence from the DiRECT clinical trial has demonstrated that people with type 2 diabetes can achieve remission with the Counterweight-Plus programme. Now the question is, how can we prevent type 2 diabetes from resurfacing? Here we will talk more about the long term results of the DiRECT trial and how people are keeping their type 2 diabetes in remission.

So, what’s the secret?

As we discussed in our blog about type 2 diabetes remission, evidence from the DiRECT clinical trial has shown that the key to achieving diabetes remission is losing weight. Participants in the DiRECT trial were followed up for two years to see how many people were able to keep their type 2 diabetes in remission. And we have to admit, the results are pretty incredible...
One-third of all people that commenced the Counterweight-Plus programme remained free of type 2 diabetes after 2 years! But how did they do it? Well, the key to sustained diabetes remission is keeping the weight off long term. If you think back to our discussion on how weight gain can lead to type 2 diabetes, it makes sense why you need to maintain this weight loss long term to remain in diabetes remission. As we mentioned, losing weight leads to a reduction in the amount of fat stored around your liver and pancreas. This allows the liver and pancreas to start working normally again, effectively reversing your type 2 diabetes.
It therefore makes sense that if you were to put this weight back on, the fat would start to build up around your pancreas again and your type 2 diabetes might return. The results also show that the likelihood of remaining in type 2 diabetes remission is linked to the amount of weight that you are able to lose. Let’s take a look at this graph:
As you can see, people who achieved and maintained a higher amount of weight loss were significantly more likely to remain in type 2 diabetes remission long term. Interestingly, participants who lost weight with the Counterweight-Plus programme also had healthier cholesterol levels, improved well-being, better blood pressure control and fewer serious medical problems. This is a great reminder that even if you aren’t able to achieve type 2 diabetes remission, there are a range of other benefits associated with losing weight!
What about the people whose type 2 diabetes returned? Well, the people who relapsed within the 2 years were those who regained more weight.

But how do I actually keep the weight off long term?

Great question! We thought long and hard about this when we were designing the Counterweight-Plus programme. There are a few things that we know are super important for helping people to keep their weight off for good:

Building sustainable habits

At the end of the day, the key to maintaining long term weight loss is finding a nutritious dietary pattern that works for you and identifying physical activity that you enjoy. This can sound quite daunting and a lot of people may feel overwhelmed at the thought of completely redesigning their lifestyle. That’s where a dietitian comes in!
Research shows that people who consult with a dietitian are able to lose more weight than people who do not have access to a dietitian¹. Our dietitians work closely with you to assess your eating and activity behaviours in order to help you identify areas where you can make a positive change. They will then guide you to create realistic goals and help you to slowly implement these changes, ultimately leading to a sustainable weight loss plan that is tailored specifically to you.

Long term support

Have you ever tried a diet and had success losing weight, only to get 6 months or a year down the track to realise you’ve regained the weight that you lost? You aren’t alone. We get it, weight loss is hard! Motivation can run low and life doesn’t stop while we try to manage our weight. That’s why one of the main focuses of our programme is making sure that you have long term support from a dietitian. They will be there to help you stay accountable and help you to deal with problems that pop up along the way.
Research shows that this ongoing interaction with a dietitian significantly improves weight maintenance in the long term, compared with short term diets with no follow-up¹. Even if we look back to the DiRECT trial, participants who completed the 12 weeks of total diet replacement but then pulled out of the programme and didn’t attend the weight maintenance appointments regained more weight than the people who stayed in the programme and had long term support. Looks like we’re in it together for the long haul!

Anticipating tough times and having a contingency plan

Wouldn’t it be great if losing weight and keeping it off was as easy as this:
What we know is that the weight management journey usually looks a little more like this:
Research shows that the majority of people who lose weight will regain weight at some stage². There are a number of biological, behavioural, and environmental factors that make it very difficult for us to maintain weight loss long term. The important thing is to identify weight regain early and stop it in its tracks before it snowballs and all of your progress is undone. That’s why we developed the Rescue Plan. You and your dietitian will work together to monitor your weight in the long term. If you notice that the number on the scales is starting to creep up again, we have a structured plan ready to go so that you can 'reset' and get back on track.
In the DiRECT trial, almost half of the participants doing the Counterweight-Plus programme used a Rescue Plan as part of their weight management journey, showing just how important it is to have a formal plan in place to catch weight regain. The combination of education and support from a dietitian, long term follow up, and a back-up plan for when things get tough is what sets our programme apart. Find out more about how you could lose weight for good and potentially put your type 2 diabetes into remission by clicking here.

Is type 2 diabetes remission permanent?

We know that participants from the DiRECT trial have been able to maintain their diabetes remission long term, but we don't yet know if diabetes remission is permanent. The DiRECT trial is still running and participants will continue to be followed up in order to get a better understanding of the long-term benefits of the Counterweight-Plus programme and whether people can stay in type 2 diabetes remission for good.
Because there is still so much we don’t know about the effects of diabetes remission, it’s important that you continue to attend your diabetes health checks and get screened for diabetes complications, even if you’re in remission. Even if type 2 diabetes remission isn’t permanent, achieving remission for a few years delays your requirement for medication and reduces your risk of complications, so there are plenty of reasons to take action and make a change!

Key points to remember

  • It is possible to remain in type 2 diabetes remission long term
  • The key to sustained diabetes remission is losing weight and keeping the weight off
  • Having long term support from a dietitian makes it easier to lose weight and maintain weight loss, click here to find out more about the programme today
  • Weight regain is a normal part of the weight management journey, identifying weight regain early and having a plan in place can stop you from going back to square one
  • People in type 2 diabetes remission still need to have regular diabetes health checks


  1. Williams LT, Barnes K, Ball L, Ross LJ, Sladdin I, Mitchell LJ. How effective are dietitians in weight management? A systematic review and meta-analysis of randomized controlled trials. InHealthcare 2019 Mar (Vol. 7, No. 1, p. 20). Multidisciplinary Digital Publishing Institute
  2. Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Medical Clinics. 2018 Jan 1;102(1):183-97.


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