GPs to prescribe 'soup and shake' diet for patients with type II diabetes

GPs in 10 areas of England can now refer patients with type II diabetes onto a 900-calorie liquid diet plan, with the aim of putting their condition into remission.

The DiRECT trial showed that a weight loss programme involving a low-calorie liquid diet for 3-5 months can induce sustained remission of type II diabetes. | GETTY IMAGES
The DiRECT trial showed that a weight loss programme involving a low-calorie liquid diet for 3-5 months can induce sustained remission of type II diabetes. | GETTY IMAGES

Eligible patients will be offered 'total diet replacement products’, including shakes and soups, providing them with up to 900 calories a day for three months.

Alongside this, patients will receive virtual one-to-one or group sessions or other digital support for a year to help them increase their exercise levels and reintroduce ordinary foods after the initial three months.

The new programme will initially be offered to up to 5,000 people in the 10 areas taking part in the pilot (see below).

NHS national clinical director for diabetes and obesity Professor Jonathan Valabhji said: 'This is the latest example of how the NHS, through our Long Term Plan, is rapidly adopting the latest evidence-based treatments to help people stay well, maintain a healthy weight and avoid major diseases.

'There has never been a more important time to lose weight and put their type 2 diabetes into remission, so it’s good news for thousands of people across the country that practical, measures like this are increasingly available on the NHS.'


To be eligible for referral to the scheme patients must have had a diagnosis of type II diabetes within the last six years and have a BMI over 27kg/m² (or over 25kg/m² in people of black, Asian and minority ethnic origin). They will need to commit to ongoing review and monitor meetings with a clinician and have attended previous reviews.

Those who are taking insulin or who have just experienced a major illness, including cancer or a heart attack, will not be eligible.

Patients on the scheme will have regular checks with a clinician, including a six-month review to assess the impact of the programme. The service provider will liaise with the GP practice about the patient's progress, but the provider will remain the patient's main point of contact while they are on the plan.

DiRECT trial

The scheme is based on the Diabetes UK-funded DiRECT trial, which assessed the impact of low-calorie meal replacements of 850 calories a day versus best available diabetes care.

The study found that 46% of those following the programme had put their type 2 diabetes into remission by the end of 12 months and 70% of these people were still in remission at the end of the second year.

Overall, more than a third (36%) of people were in remission two years after taking part in the programme. The study has found that remission is closely linked to weight loss.

Those who were in remission after one year, and who had stayed in remission, had lost a greater amount of weight on average than those who did not stay in remission.

First step

Diabetes UK director of policy campaigns and improvement Bridget Turner said: 'This is an important first step to ensure that people with type 2 diabetes, can access a remission programme within the NHS and benefit from the ground-breaking findings of the Diabetes UK funded DiRECT research.

'We know that some people with type 2 diabetes want and need support from health care professionals to lose weight effectively and now as these programmes are piloted across the NHS - they will. [We] hope that it won’t be too long before more remission programmes are rolled out across the country.'

The sites involved with the pilot programme are:

  • South Yorkshire and Bassetlaw ICS
  • Humber Coast and Vale
  • Greater Manchester Health and Social Care Partnership
  • Frimley Health and Care STP
  • Gloucestershire STP
  • Derbyshire
  • Birmingham and Solihull STP
  • Bedfordshire, Luton and Milton Keynes
  • North East London
  • North Central London
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