The Study
The Effect of Integrated Lifestyle Intervention Incorporating Calorie‐Carbohydrate Restriction With or Without Time‐Restricted Feeding for Remission of Type 2 Diabetes (DIREM): A Single Blind Randomised Controlled Trial
This study is like a fair test where people were randomly picked to try different diets to see if they could get their diabetes better. It shows that these diets helped some people get their blood sugar down without medicine, but we can't say for sure that the diets caused it because not enough people were in the study to be super sure.
Analysis score
Maximum 90 for a randomized controlled trial.
Where the score came from
This study tested if eating fewer calories and carbs — with or without only eating during an 8-hour window — could help people with early type 2 diabetes stop needing medicine.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 581 / 100
Quality score
Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — losing even 5–10 pounds helped over 40% of people reverse their diabetes without drugs, which is a big deal for daily life and health.
- 222.5% of people who ate less calories and carbs got their blood sugar back to normal without medicine.
- 330% who also skipped meals between dinner and breakfast got better — but not significantly more.
- 4Every pound lost made it 2.28 times more likely they’d go into remission.
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Endocrinology, Diabetes & Metabolism
Year
2026
Authors
Negin Badrooj, Alireza Esteghamati, Koroush Djafarian, M. Yekaninejad, Saba Mohammadpour, Vida Dankoob, S. K. Reyhan, Mahsa Abbaszade, S. Emamgholipour, Sakineh Shab-Bidar
Related Content
Claims (5)
Among adults with recently diagnosed type 2 diabetes, a structured diet limiting calories and carbohydrates for six months leads to diabetes remission in about 22.5% of people, while only 2.5% of those receiving standard care achieve remission.
Among adults with early-stage type 2 diabetes, adding a 16:8 fasting schedule to a reduced-calorie and reduced-carbohydrate diet does not lead to a higher rate of diabetes remission than the diet alone.
In adults with early-stage type 2 diabetes, losing one kilogram of body weight is linked to a 2.28 times higher chance of achieving diabetes remission, defined as HbA1c below 6.5% without medication.
Among adults with early-stage type 2 diabetes, following a 6-month diet that limits calories and carbohydrates leads to a 70% reduction in the use of antidiabetic medications, particularly sulfonylureas and SGLT2 inhibitors.
Eating fewer calories while keeping protein and carbohydrate intake at moderate levels lowers insulin and IGF-1 levels and triggers autophagy.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.