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‘I’ve got my life back’exclaims a participant from the Diabetes UK–funded Diabetes Remission Clinical Trial (DiRECT). She is not the first to use that expression, reflecting a 2014 national survey by the James Lind Alliance. People living with type 2 diabetes (T2D) ranked as their number one priority for research ‘whether T2D can be cured or reversed’. Diabetes UK, a patient–professional charity, funded DiRECT to answer that very question.

The thinking was simple. Until~ 40 years ago, T2D only affected older people. With an average age of onset of~ 70 years, relatively few lived long enough to run into serious difficulties from their diabetes. The worldwide epidemic of overweight and obesity has changed all that, teaching us that T2D is a nutritional disease: almost nobody gets T2D unless they become overweight. And with earlier weight gains, the average age at diagnosis has fallen dramatically to~ 50 years, so …