{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:56:17Z","timestamp":1781805377338,"version":"3.54.5"},"reference-count":37,"publisher":"American Diabetes Association","issue":"5","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100011947","name":"Abbott Nutrition","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011947","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,12,15]]},"abstract":"<jats:p>This article reports on the feasibility and effectiveness of a 12-week program, including a low-calorie diet using a diabetes-specific nutritional formula meal replacement, a digitally enabled self-management app, and coaching, on measurable outcomes of weight, BMI, A1C levels, and blood pressure in adults with type 2 diabetes and excess body weight. Participation in the program reduced body weight by a mean 11 \u00b1 6.5 kg, BMI by 3.7 \u00b1 2.2 kg\/m2, A1C by 1%, systolic blood pressure by 4.5 \u00b1 16.1 mmHg, and diastolic blood pressure by 5.8 \u00b1 16.9 mmHg (all P &amp;lt;0.01).<\/jats:p>","DOI":"10.2337\/cd25-0054","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T20:51:03Z","timestamp":1760647863000},"page":"772-780","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":3,"title":["A Pathway to Type 2 Diabetes Remission: Weight Reduction and A1C Improvements Are Facilitated by a Low-Calorie Diet Including Diabetes-Specific Nutritional Formula and the Use of Digitally Enabled Reinforcement"],"prefix":"10.2337","volume":"43","author":[{"given":"Michael","family":"Trenell","sequence":"first","affiliation":[{"name":"Changing Health Ltd. 1 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Camprubi Robles","sequence":"additional","affiliation":[{"name":"Abbott Nutrition R&D 2 , Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Taylor","sequence":"additional","affiliation":[{"name":"Changing Health Ltd. 1 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicky","family":"Northway","sequence":"additional","affiliation":[{"name":"Changing Health Ltd. 1 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8777-4775","authenticated-orcid":false,"given":"Kirk W.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Abbott Laboratories 3 , Abbott Park, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Lumsden","sequence":"additional","affiliation":[{"name":"Changing Health Ltd. 1 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Avery","sequence":"additional","affiliation":[{"name":"School of Health and Life Sciences, Teesside University 4 , Tees Valley, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Faluyi","sequence":"additional","affiliation":[{"name":"Changing Health Ltd. 1 , London, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Rueda","sequence":"additional","affiliation":[{"name":"Abbott Nutrition R&D 2 , Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7567-147X","authenticated-orcid":false,"given":"Suela","family":"Sulo","sequence":"additional","affiliation":[{"name":"Abbott Laboratories 3 , Abbott Park, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"2026061813410650300_B1","unstructured":"International Diabetes Federation\n          . The Diabetes Atlas. Available from https:\/\/diabetesatlas.org. Accessed 9 July 2025"},{"key":"2026061813410650300_B2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.2991\/jegh.k.191028.001","article-title":"Epidemiology of type 2 diabetes: global burden of disease and forecasted trends","volume":"10","author":"Khan","year":"2020","journal-title":"J Epidemiol Glob Health"},{"key":"2026061813410650300_B3","doi-asserted-by":"crossref","first-page":"172","DOI":"10.3390\/nu16010172","article-title":"The vicious cycle of type 2 diabetes mellitus and skeletal muscle atrophy: clinical, biochemical, and nutritional bases","volume":"16","author":"Lopez-Pedrosa","year":"2024","journal-title":"Nutrients"},{"key":"2026061813410650300_B4","doi-asserted-by":"crossref","first-page":"26","DOI":"10.2337\/dci23-0085","article-title":"Economic costs of diabetes in the U.S. in 2022","volume":"47","author":"Parker","year":"2024","journal-title":"Diabetes Care"},{"key":"2026061813410650300_B5","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s40273-014-0243-x","article-title":"The epidemiology of obesity: a big picture","volume":"33","author":"Hruby","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"2026061813410650300_B6","doi-asserted-by":"crossref","first-page":"q516","DOI":"10.1136\/bmj.q516","article-title":"Even short periods of diabetes remission are linked to lower risk of heart attack and stroke","volume":"384","author":"Saul","year":"2024","journal-title":"BMJ"},{"key":"2026061813410650300_B7","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/S2213-8587(24)00036-6","article-title":"Type 2 diabetes remission: weight maintenance in the spotlight","volume":"12","author":"Taheri","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026061813410650300_B8","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1136\/ebnurs-2023-103923","article-title":"Remission of type 2 diabetes is achievable in primary care with intensive lifestyle intervention","volume":"28","author":"Zoungas","year":"2025","journal-title":"Evid Based Nurs"},{"key":"2026061813410650300_B9","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/S0140-6736(17)33102-1","article-title":"Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial","volume":"391","author":"Lean","year":"2018","journal-title":"Lancet"},{"key":"2026061813410650300_B10","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/dom.15819","article-title":"The latest evidence and clinical guidelines for use of meal replacements in very-low-calorie diets or low-calorie diets for the treatment of obesity","volume":"26","author":"Edwards-Hampton","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"2026061813410650300_B11","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/obr.12816","article-title":"A systematic review and meta-analysis of the effectiveness of meal replacements for weight loss","volume":"20","author":"Astbury","year":"2019","journal-title":"Obes Rev"},{"key":"2026061813410650300_B12","doi-asserted-by":"crossref","first-page":"295S","DOI":"10.1038\/oby.2001.134","article-title":"Very-low-calorie diets and sustained weight loss","volume":"9","author":"Saris","year":"2001","journal-title":"Obes Res"},{"key":"2026061813410650300_B13","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1007\/s00125-022-05787-2","article-title":"Management of hyperglycaemia in type 2 diabetes, 2022: a consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"65","author":"Davies","year":"2022","journal-title":"Diabetologia"},{"key":"2026061813410650300_B14","unstructured":"NHS England\n          . Clinical audit. Available from https:\/\/www.england.nhs.uk\/clinaudit. Accessed 9 July 2025"},{"key":"2026061813410650300_B15","doi-asserted-by":"crossref","first-page":"2267","DOI":"10.2337\/diacare.28.9.2267","article-title":"Enteral nutritional support and use of diabetes-specific formulas for patients with diabetes: a systematic review and meta-analysis","volume":"28","author":"Elia","year":"2005","journal-title":"Diabetes Care"},{"key":"2026061813410650300_B16","doi-asserted-by":"crossref","first-page":"3616","DOI":"10.3390\/nu12123616","article-title":"Diabetes-specific nutrition formulas in the management of patients with diabetes and cardiometabolic risk","volume":"12","author":"Mechanick","year":"2020","journal-title":"Nutrients"},{"key":"2026061813410650300_B17","first-page":"291","article-title":"Nutrition interventions for remission of type 2 diabetes: potential role for diabetes-specific nutrition formulas","volume":"43","author":"Trenell","year":"2025","journal-title":"Clin Diabetes"},{"key":"2026061813410650300_B18","doi-asserted-by":"crossref","first-page":"874968","DOI":"10.3389\/fendo.2022.874968","article-title":"Is there a role for diabetes-specific nutrition formulas as meal replacements in type 2 diabetes?","volume":"13","author":"Noronha","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026061813410650300_B19","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1748-5908-6-42","article-title":"The Behaviour Change Wheel: a new method for characterising and designing behaviour change interventions","volume":"6","author":"Michie","year":"2011","journal-title":"Implement Sci"},{"key":"2026061813410650300_B20","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/S2213-8587(19)30068-3","article-title":"Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial","volume":"7","author":"Lean","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026061813410650300_B21","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S2213-8587(23)00385-6","article-title":"5-Year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study","volume":"12","author":"Lean","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026061813410650300_B22","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1136\/bmj.321.7258.405","article-title":"Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study","volume":"321","author":"Stratton","year":"2000","journal-title":"BMJ"},{"key":"2026061813410650300_B23","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1002\/oby.20662","article-title":"Eight-year weight losses with an intensive lifestyle intervention: the Look AHEAD study","volume":"22","author":"Look Ahead Research Group","year":"2014","journal-title":"Obesity (Silver Spring)"},{"key":"2026061813410650300_B24","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1001\/jama.2012.67929","article-title":"Association of an intensive lifestyle intervention with remission of type 2 diabetes","volume":"308","author":"Gregg","year":"2012","journal-title":"JAMA"},{"key":"2026061813410650300_B25","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00125-023-06048-6","article-title":"Impact of remission from type 2 diabetes on long-term health outcomes: findings from the Look AHEAD study","volume":"67","author":"Gregg","year":"2024","journal-title":"Diabetologia"},{"key":"2026061813410650300_B26","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1136\/dtb.2022.000055","article-title":"Very low calorie diets and total diet replacement in type 2 diabetes: where are we now?","volume":"62","author":"Taylor","year":"2024","journal-title":"Drug Ther Bull"},{"key":"2026061813410650300_B27","doi-asserted-by":"crossref","first-page":"e14689","DOI":"10.1111\/dme.14689","article-title":"Participant experiences in the Diabetes REmission Clinical Trial (DiRECT)","volume":"39","author":"Rehackova","year":"2022","journal-title":"Diabet Med"},{"key":"2026061813410650300_B28","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1056\/NEJMoa1414266","article-title":"Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes","volume":"372","author":"Hayward","year":"2015","journal-title":"N Engl J Med"},{"key":"2026061813410650300_B29","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1056\/NEJMoa1800256","article-title":"Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes","volume":"379","author":"Rawshani","year":"2018","journal-title":"N Engl J Med"},{"key":"2026061813410650300_B30","doi-asserted-by":"crossref","first-page":"e0290791","DOI":"10.1371\/journal.pone.0290791","article-title":"Type 2 diabetes remission trajectories and variation in risk of diabetes complications: a population-based cohort study","volume":"18","author":"Dambha-Miller","year":"2023","journal-title":"PLoS One"},{"key":"2026061813410650300_B31","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S2213-8587(24)00194-3","article-title":"Early findings from the NHS Type 2 Diabetes Path to Remission Programme: a prospective evaluation of real-world implementation","volume":"12","author":"Valabhji","year":"2024","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026061813410650300_B32","doi-asserted-by":"crossref","first-page":"e14752","DOI":"10.1111\/dme.14752","article-title":"Delivering the Diabetes Remission Clinical Trial (DiRECT) in primary care: experiences of healthcare professionals","volume":"39","author":"Rehackova","year":"2022","journal-title":"Diabet Med"},{"key":"2026061813410650300_B33","doi-asserted-by":"crossref","first-page":"1400580","DOI":"10.3389\/fnut.2024.1400580","article-title":"Diabetes-specific formula with standard of care improves glycemic control, body composition, and cardiometabolic risk factors in overweight and obese adults with type 2 diabetes: results from a randomized controlled trial","volume":"11","author":"Tey","year":"2024","journal-title":"Front Nutr"},{"key":"2026061813410650300_B34","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.3390\/nu11081905","article-title":"The effect of diabetes-specific enteral nutrition formula on cardiometabolic parameters in patients with type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials","volume":"11","author":"Ojo","year":"2019","journal-title":"Nutrients"},{"key":"2026061813410650300_B35","doi-asserted-by":"crossref","first-page":"3273","DOI":"10.1016\/j.clnu.2020.02.036","article-title":"Diabetes-specific formulas high in monounsaturated fatty acids and metabolic outcomes in patients with diabetes or hyperglycaemia: a systematic review and meta-analysis","volume":"39","author":"Sanz-Par\u00eds","year":"2020","journal-title":"Clin Nutr"},{"key":"2026061813410650300_B36","doi-asserted-by":"crossref","first-page":"e13733","DOI":"10.1111\/obr.13733","article-title":"Physiological and psychological determinants of long-term diet-induced type 2 diabetes (T2DM) remission: a narrative review","volume":"25","author":"Aksoy","year":"2024","journal-title":"Obes Rev"},{"key":"2026061813410650300_B37","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1111\/dme.14096","article-title":"Inducing remission of type 2 diabetes in the Caribbean: findings from a mixed methods feasibility study of a low-calorie liquid diet-based intervention in Barbados","volume":"37","author":"Bynoe","year":"2020","journal-title":"Diabet Med"}],"container-title":["Clinical Diabetes"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/clinical\/article-pdf\/43\/5\/772\/844559\/diaclincd250054.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/clinical\/article-pdf\/43\/5\/772\/844559\/diaclincd250054.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T17:41:20Z","timestamp":1781804480000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/clinical\/article\/43\/5\/772\/163627\/A-Pathway-to-Type-2-Diabetes-Remission-Weight"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":37,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,10,16]]},"published-print":{"date-parts":[[2025,12,15]]}},"URL":"https:\/\/doi.org\/10.2337\/cd25-0054","relation":{},"ISSN":["0891-8929","1945-4953"],"issn-type":[{"value":"0891-8929","type":"print"},{"value":"1945-4953","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]}}}