Re: Type 2 diabetes: 5000 patients to test feasibility of “remission service”
As a GP trainee, I read with interest this article on the "remission service" set to roll out in primary care. The DIRECT trial engenders particular interest in the benefits of rapid weight loss among overweight diabetics with demonstrated remission for 1 year. I think that any effort to help kick start motivation to lose weight is a good and worthwhile service provision. However, this essentially takes more responsibility of maintaining a healthy lifestyle out of patients' hands. Although spoon feeding success to meet our endpoint is not morally wrong, I fear that this might create a culture of dependence upon our health service and essentially take all responsibility out of patients' hands. In this environment, it is questionable whether this lifestyle introduced in a controlled environment within the DIRECT can be a sustainable, or if remission can continue beyond 1 year once the programme ceases?
I look forward to a long term solution in helping people to lose weight and tackling the crux of the problem - the surge in diabetes in our western society. This ailment of the 21st century is not an easy giant to wrestle with as the obvious solution is strong, sustainable motivation which cannot be bought with money. In fact, it is also shown in the DIRECT trial that those who left the programme with its controlled environment had gained back their weight significantly. Perhaps there will be a group of patients, who after the baptism of fire, will have their motivation tested and come out as a true winner not in the pounds they have shed, but in refining and strengthening their willpower.
Rapid Response:
Re: Type 2 diabetes: 5000 patients to test feasibility of “remission service”
As a GP trainee, I read with interest this article on the "remission service" set to roll out in primary care. The DIRECT trial engenders particular interest in the benefits of rapid weight loss among overweight diabetics with demonstrated remission for 1 year. I think that any effort to help kick start motivation to lose weight is a good and worthwhile service provision. However, this essentially takes more responsibility of maintaining a healthy lifestyle out of patients' hands. Although spoon feeding success to meet our endpoint is not morally wrong, I fear that this might create a culture of dependence upon our health service and essentially take all responsibility out of patients' hands. In this environment, it is questionable whether this lifestyle introduced in a controlled environment within the DIRECT can be a sustainable, or if remission can continue beyond 1 year once the programme ceases?
I look forward to a long term solution in helping people to lose weight and tackling the crux of the problem - the surge in diabetes in our western society. This ailment of the 21st century is not an easy giant to wrestle with as the obvious solution is strong, sustainable motivation which cannot be bought with money. In fact, it is also shown in the DIRECT trial that those who left the programme with its controlled environment had gained back their weight significantly. Perhaps there will be a group of patients, who after the baptism of fire, will have their motivation tested and come out as a true winner not in the pounds they have shed, but in refining and strengthening their willpower.
Competing interests: No competing interests