Physiological and psychological determinants of long-term diet-induced type 2 diabetes (T2DM) remission: A narrative review

Ayse Nur Aksoy*, Julie Abayomi, Nicola Relph, Thomas Butler

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Type 2 diabetes mellitus (T2DM) is a highly prevalent metabolic disease, causing a heavy burden on healthcare systems worldwide, with related complications and anti-diabetes drug prescriptions. Recently, it was demonstrated that T2DM can be put into remission via significant weight loss using low-carbohydrate diets (LCDs) and very low-energy diets (VLEDs) in individuals with overweight and obesity. Clinical trials demonstrated remission rates of 25–77%, and metabolic improvements such as improved blood lipid profile and blood pressure were observed. In contrast, clinical trials showed that remission rate declines with time, concurrent with weight gain, or diminished weight loss. This review aims to discuss existing literature regarding underlying determinants of long-term remission of T2DM including metabolic adaptations to weight loss (e.g., role of gastrointestinal hormones), type of dietary intervention (i.e., LCDs or VLEDs), maintaining beta (β)-cell function, early glycemic control, and psychosocial factors. This narrative review is significant because determining the factors that are associated with challenges in maintaining long-term remission may help in designing sustainable interventions for type 2 diabetes remission.

Original languageEnglish
Article numbere13733
Pages (from-to)1-8
Number of pages8
JournalObesity Reviews
Early online date21 Mar 2024
Publication statusPublished - 21 Mar 2024


  • type 2 diabetes
  • legacy effect
  • remission
  • maintenance of remission

Research Institutes

  • Health Research Institute


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