The ACLM have written a general consensus paper for guidelines for remission of type 2 diabetes (Rosenfeld, et al., 2022). Consensus statements include:

• Diet is the cornerstone for managing T2DM and can be used in combination with medical therapy.
• Intensity of intervention has an impact
• Needs to be acceptable to most patients and accommodate patient preferences
• Diets need to consider a lower risk of CVD too.
• Right diet can also improve cholesterol profile.
• Reduction of calorie intake by: reducing portion size, volume and/or density of energy
• Whole food plant-based diet (WFPB) – whole-grains, vegetable, legumes, fruits, nuts and seeds.
• A very low-carb diet may influence risk of cardiovascular disease so unadvisable for long-term remission.
• Combined with physical activity improves the chance of positive outcomes.
• Intermittent fasting can also help with remission.
• Long-term diets include Mediterranean, dietary approaches to stop hypertension (DASH), and WFPB.
• Nutritional therapy can support.
• Self-management can provide patients with feedback – e.g. blood pressure and blood glucose monitoring.
• The percentage of weight loss is important rather than the absolute number.
• Provider knowledge, experience and ability for supportive communication are essential qualities.
• Lower energy dense foods, water rich foods, fruit and veg, increased fibre and low-fat, whole-grain and legumes.
• Therefore plant-based dietary patterns can be highly effective.
• Other strategies that are successful: very low calorie, fasting-mimicking and intermittent fasting.
• Nutrient dense: Mediterranean, DASH, WFPB, Fibre, anti-oxidants, phytochemicals
• Minimise: ultra-processed / meat / animal products
• Ultra-processed includes cheese, red meat, processed meat – these increase the risk of advice outcomes.
• Very low-fat diets help to reduce liver fat and improve insulin sensitivity
• Ketogenic – not advisable in the long-term. While it improves sugar it didn’t deal with some of the underlying issues: i.e. insulin sensitivity in animal studies
• Nutrition knowledge is a key driver of diet quality.