At this year’s Diabetes UK Professional Conference, results from the second year of the Diabetes Remission Clinical Trial (DiRECT) were presented. The data for diabetes control, HbA1c, and weight management suggest that intensive weight management has the potential to reduce or delay complications of diabetes and improve clinical outcomes; type 2 diabetes is potentially reversible through weight loss and it is therefore not necessarily a lifelong condition. This has the potential to revolutionise treatment, and means that in the future, early remission may become the primary management target for type 2 diabetes. Research in this area is ongoing and it could be a while before such evidence is adopted in guideline recommendations, but it is interesting to see how the landscape is evolving and speculate about what the future may hold for the management of type 2 diabetes.
In October 2018, the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) published an updated consensus report on the management of hyperglycaemia in type 2 diabetes to reflect new evidence published since the 2015 consensus statement. The updated report puts additional emphasis on holistic, person-centred care and includes a new approach to the selection of glucose-lowering medication based on the patient’s individual co‑morbidities and characteristics. Dr Clare Hambling and Dr Patrick Holmes highlight the key recommendations from the joint ADA/EASD consensus report and describe the factors that influence treatment choice.