A pilot randomised controlled trial of a Diabetes Remission Clinical Trial (DiRECT)-type intervention within a primary care service demonstrated greater weight loss than dietitian-supported usual care among 40 adults with obesity, type 2 diabetes or prediabetes. The primary care service catered to Māori, Pacific, refugee, and low-income clientele. Weight loss with the DiRECT-type intervention (3 months of total diet replacement followed by 9 months of food reintroduction and supported weight loss maintenance) was 6.1 kg greater at 3 months than with dietitian-supported usual care. At 12 months, the difference in weight loss decreased to 3.8 kg, due to gradual weight loss in the dietitiansupported usual care group. A meta-analysis of DiRECT-type interventions performed by the authors indicated 8.5 and 6.0 kg greater weight loss at 3 and 12 months, respectively, than usual diabetes care. The study authors stated that their findings demonstrate the potential use of DiRECT-type approaches across a broader patient population.
