We've known that low-calorie dieting has this effect for some time; unless I'm missing something, this looks like solid confirmation of this point but isn't adding much knew to our understanding of diabetes prevention. The big challenges in this space are adherence, scaling access to treatment and creating long-term lifestyle change that will help the patient maintain the weight that is lost.

There's good evidence that ketogenic diets have an additive metabolic effect beyond pure calorie restriction which is exciting. Virta Health is doing some interesting work here and just published some results that speak to this: https://link.springer.com/article/10.1007%2Fs13300-018-0373-...