Rewriting the diabetes script: Landmark trial challenges ‘one-way’ disease narrative

Australians living with type 2 diabetes stand to benefit from a new digital program centred on nutrition education and behavioural change, with early findings suggesting it may support reversal of the condition and improve disease management outcomes.

Type 2 diabetes now affects more than 1.7 million people across Australia, with diagnoses nearly tripling over the past two decades. Its impact extends well beyond clinical outcomes, placing substantial pressure on the health system, with annual direct healthcare costs exceeding $3 billion. When broader economic losses such as reduced productivity and long-term care are included, the estimated burden rises by a further $17.6 billion.

Against this backdrop, researchers from La Trobe University have evaluated the outcomes of a first-of-its-kind Australian study evaluating a 12-month, digitally delivered program designed to support type 2 diabetes management through structured nutrition therapy and behaviour change education. The program, which integrates dietary guidance with ongoing digital support, was assessed for its impact on medication use, metabolic health markers and patient-reported wellbeing.

The findings have prompted strong reactions from clinicians involved in the research, including Dr Ron Schweitzer, a general practitioner specialising in metabolic health and one of the clinicians behind the study.

“The old narrative – that type 2 diabetes is a one-way street toward more medication – simply doesn’t hold up,” he said. “In my practice, I’ve seen the Defeat Diabetes app help patients achieve real, lasting improvements that outperform medication. Many have been able to reduce their prescriptions or stop taking anti-diabetes drugs entirely.”

Across the study cohort, researchers reported that one in five participants were able to maintain blood glucose levels below 6.5% after discontinuing glucose-lowering medication altogether, a result interpreted as diabetes reversal. Among those already taking medication at baseline, 13% were able to cease all diabetes-related drugs during the study period. In addition, 10% stopped all blood pressure medication, while 7% discontinued cholesterol-lowering medication.

Improvements were also observed in key biomarkers of metabolic health, with liver function indicators including ALT and GGT showing significant gains, suggesting benefits extending beyond glycaemic control. Participants also reported meaningful quality-of-life improvements, including a 9-point increase in self-reported wellbeing, a 5-point rise in confidence in managing their condition, and a marked reduction in diabetes-related distress.

For Sladjana Cukanic, a type 2 diabetes diagnosis and the prospect of managing a lifelong condition felt overwhelming. Looking for support to better understand her options.

“I didn’t want to be on medications from the start, but I knew something had to change. In just 7 months of following the Defeat Diabetes program, I’ve lost 9kg, my blood glucose has returned to normal, and I have more energy throughout the day. I feel more in control of my health than I ever have. I did it all by changing what I eat,” she said.

The study brings long-overdue clinical backing to what many clinicians have already witnessed in practice.

“As the longest and most comprehensive real-world trial of a digitally-delivered low-carbohydrate nutrition program in Australia, it makes a clear case: structured dietary support isn’t an alternative to standard diabetes care – it should be at the heart of it,” said Dr Schweitzer.

With both prevalence and cost of diabetes expected to continue rising, Professor Peter Brukner, Sports and Exercise Physician and founder of Defeat Diabetes, said the findings highlight an urgent need to rethink conventional management approaches to type 2 diabetes.

“For too long, millions of Australians with type 2 diabetes have been left without hope. The standard approach has been to diagnose, medicate and monitor the decline. These results say otherwise. Nutrition therapy produces outcomes that medication alone rarely achieves and yet access to this kind of education remains out of reach for most people. That is not acceptable,” Professor Brukner said. “This study shows that, for many Australians, the right nutrition education and care can lead to clinically significant improvements in health outcomes that are sustained longer-term.”

He added, “More than three billion dollars leaves the Australian healthcare system every year because of diabetes. We cannot keep ignoring what the evidence is telling us.”

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