At 6 months, LCDs achieved higher rates of diabetes remission compared with control diets. Large clinically important improvements were seen in BW loss, TG, and insulin sensitivity at 6 months, though they were diminished at 12 months. VLCDs were less effective than less restrictive LCDs for BW loss at 6 months, but this was explained by diet adherence. Here, INS is linked to diabetes mellitus.