Welcome & Session 1
| Wednesday, April 28, 2021 |
| 8:45 - 9:55 |
Speaker
Professor Carel Le Roux
IrSPEN Director
Welcome Address
8:45 - 9:00Biography
Professor Carel le Roux graduated from medical school in Pretoria South Africa, completed his specialist training in metabolic medicine at St Bartholomew’s Hospitals and the Hammersmith Hospitals. He obtained his PhD from Imperial College London where he later took up a faculty position. He moved to University College Dublin for the Chair in Experimental Pathology and he is now a Director of the Metabolic Medicine Group. He also holds the position of Professor of Metabolic Medicine at Ulster University. He currently coordinates an Innovative Medicine Initiative project on obesity. He previously received a President of Ireland Young Researcher Award, Irish Research Council Laurate Award, Clinician Scientist Award from the National Institute Health Research in the UK, and a Wellcome Trust Clinical Research Fellowship for his work on how the gut talks to the brain.
Professor Shahrad Taheri
Weill Cornell Medicine
Evidence that total meal replacement therapy (TMRT) can be used to place diabetes into remission
9:00 - 9:20Abstract
Evidence that total meal replacement therapy (TMRT) can be used to place diabetes into remission (Shahrad Taheri)
Type 2 diabetes is affecting people at an increasingly younger age, particularly in the Middle East and in north Africa (MENA) region. We assessed whether an intensive lifestyle intervention incorporationg a total meal replacement phase followed by gradual food reintroduction would lead to significant weight loss and improved glycaemia in young individuals with early diabetes.
This open-label, parallel-group, randomised controlled trial (DIADEM-I), done in primary care and community settings in Qatar, compared the effects of an intensive lifestyle intervention with usual medical care on weight loss and glycaemic outcomes in individuals with type 2 diabetes, aged 18–50 years, with a short diabetes duration (≤3 years), had a BMI of 27·0 kg/m2 or more, and who were from the MENA region. Participants were randomly allocated (1:1) either to the intensive lifestyle intervention group or the usual medical care control group by a computer-generated sequence and an online randomisation service. The intensive lifestyle intervention comprised a total diet replacement phase, in which participants were given formula low-energy diet meal replacement products followed by gradual food reintroduction combined with physical activity support, and a weight-loss maintenance phase, involving structured lifestyle support. Participants in the control group received usual diabetes care, which was based on clinical guidelines. The primary outcome was weight loss at 12 months after receiving the assigned intervention. Our analysis was based on the intention-to-treat principle. Key secondary outcomes included diabetes control and remission. The trial was registered with the ISRCTN registry, ISRCTN20754766, and ClinicalTrials.gov, NCT03225339.
Between July 16, 2017, and Sept 30, 2018, we enrolled and randomly assigned 158 participants (n=79 in each group) to the study. 147 participants (70 in the intervention group and 77 in the control group) were included in the final intention-to-treat analysis population. Between baseline and 12 months, the mean bodyweight of participants in the intervention group reduced by 11·98 kg compared with 3·98 kg in the control group (adjusted mean difference −6·08 kg, p<0·0001). In the intervention group, 21% of participants achieved more than 15% weight loss between baseline and 12 months compared with 1% of participants in the control group (p<0·0001). Diabetes remission occurred in 61% of participants in the intervention group compared with 12% of those in the control group (p<0·0001). 33% of participants in the intervention group had normoglycaemia compared with 4% of participants in the control group (OR 12·07 [3·43 to 42·45], p<0·0001).
The talk will discuss findings from the DIADEM-I study, factors related to diabetes remission, and translation of findings into clinical care.
Type 2 diabetes is affecting people at an increasingly younger age, particularly in the Middle East and in north Africa (MENA) region. We assessed whether an intensive lifestyle intervention incorporationg a total meal replacement phase followed by gradual food reintroduction would lead to significant weight loss and improved glycaemia in young individuals with early diabetes.
This open-label, parallel-group, randomised controlled trial (DIADEM-I), done in primary care and community settings in Qatar, compared the effects of an intensive lifestyle intervention with usual medical care on weight loss and glycaemic outcomes in individuals with type 2 diabetes, aged 18–50 years, with a short diabetes duration (≤3 years), had a BMI of 27·0 kg/m2 or more, and who were from the MENA region. Participants were randomly allocated (1:1) either to the intensive lifestyle intervention group or the usual medical care control group by a computer-generated sequence and an online randomisation service. The intensive lifestyle intervention comprised a total diet replacement phase, in which participants were given formula low-energy diet meal replacement products followed by gradual food reintroduction combined with physical activity support, and a weight-loss maintenance phase, involving structured lifestyle support. Participants in the control group received usual diabetes care, which was based on clinical guidelines. The primary outcome was weight loss at 12 months after receiving the assigned intervention. Our analysis was based on the intention-to-treat principle. Key secondary outcomes included diabetes control and remission. The trial was registered with the ISRCTN registry, ISRCTN20754766, and ClinicalTrials.gov, NCT03225339.
Between July 16, 2017, and Sept 30, 2018, we enrolled and randomly assigned 158 participants (n=79 in each group) to the study. 147 participants (70 in the intervention group and 77 in the control group) were included in the final intention-to-treat analysis population. Between baseline and 12 months, the mean bodyweight of participants in the intervention group reduced by 11·98 kg compared with 3·98 kg in the control group (adjusted mean difference −6·08 kg, p<0·0001). In the intervention group, 21% of participants achieved more than 15% weight loss between baseline and 12 months compared with 1% of participants in the control group (p<0·0001). Diabetes remission occurred in 61% of participants in the intervention group compared with 12% of those in the control group (p<0·0001). 33% of participants in the intervention group had normoglycaemia compared with 4% of participants in the control group (OR 12·07 [3·43 to 42·45], p<0·0001).
The talk will discuss findings from the DIADEM-I study, factors related to diabetes remission, and translation of findings into clinical care.
Biography
Professor Shahrad Taheri is Professor of Medicine at Weill Cornell Medicine. He is also Senior Consultant Physician in Diabetes and Endocrinology and Assistant Chair in Medicine at Hamad Medical Corporation, Qatar. Professor Taheri has been a member of the National Diabetes Strategy Committee in Qatar. He chairs the Research Committee for the Qatar National Diabetes Strategy and also for the Qatar Metabolic Institute. He graduated in Medicine from London University and obtained his PhD from Imperial College London, followed by post-doctoral research training at Stanford University as a Howard Hughes Research Associate. Professor Taheri has extensive experience in leading large multi-disciplinary clinical and research teams. He has over 150 publications and has won several awards for his research. Professor Taheri’s focus is the design and conduct of clinical trials to answer key questions in the management of metabolic diseases and linking these to basic laboratory investigations to understand underlying molecular mechanisms.
Professor Francis Finucane
Consultant Endocrinologist, Galway University Hospitals and NUI Galway
How can TMRT be implemented in practice
9:20 - 9:40Abstract
How can TMRT be implemented in practice (Francis Finucane)
This talk will examine the evidence base and indications for meal replacement programmes, reflecting some real world challenges and experiences.
This talk will examine the evidence base and indications for meal replacement programmes, reflecting some real world challenges and experiences.
Biography
Francis Finucane is a consultant endocrinologist at Galway University Hospitals and NUIG. He was awarded an MD from the University of Dublin (TCD) for research on the mechanistic basis for type 2 diabetes in young people. He completed an MRC-funded post-doctoral career development fellowship at the Institute of Metabolic Science in Cambridge, where he studied the effects of structured lifestyle modification on metabolic risk. In Galway, he established a regional bariatric medical service for patients with severe and complicated obesity and received the inaugural Clinical Research Career Development Award from Saolta in 2019.
Chair
John Conneely
Mater Misericordiae University Hospital
Host
Kelsey Harte O'Brien
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