WHILE it is good to see local research reaching international prominence, I am not sure that the DiRECT trial tells us anything we did not know already about Type2 diabetes (“Low-calorie diet can beat Type 2 diabetes without drugs, study finds”, The Herald, December 6).

Both the Scottish Intercollegiate Guidelines Network (Sign, management of diabetes) and Nice in England (Diabetes in adults: management) emphasise weight loss and exercise as first line treatments so I think the authors err when they say, for example that “diabetes remission by cutting calories is rarely discussed”.

All GPs will have seen people who have sorted out their own diabetes by improving their lifestyle and losing weight.

Sadly, they will also have seen many who find this too challenging. They are probably not helped by the supermarkets, with entire aisles devoted to crisps and fizzy drinks or by the media when it equates “exercise” with going to the gym in lycra, rather than walking, cycling or gardening.

Perhaps instead of telling us how we’re getting it wrong, the next study could be devoted to how we achieve, and maintain, the sort of lifestyle changes that are desired for the entire population?

Dr David Syme, GP,


Loch Tay,