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J Diabetes Complications. 2014 Jul-Aug;28(4):506-10. doi: 10.1016/j.jdiacomp.2014.03.014. Epub 2014 Mar 29.

Very-low-energy diet for type 2 diabetes: an underutilized therapy?

Author information

1
University of Michigan, Department of Internal Medicine (AER, LNM, ATK, CEF); University of Michigan, Departments of Internal Medicine and Epidemiology (WHH). Electronic address: arothber@umich.edu.
2
University of Michigan, Department of Internal Medicine (AER, LNM, ATK, CEF); University of Michigan, Departments of Internal Medicine and Epidemiology (WHH).

Abstract

BACKGROUND:

Current approaches to the management of type 2 diabetes focus on the early initiation of novel pharmacologic therapies and bariatric surgery.

OBJECTIVE:

The purpose of this study was to revisit the use of intensive, outpatient, behavioral weight management programs for the management of type 2 diabetes.

DESIGN:

Prospective observational study of 66 patients with type 2 diabetes and BMI ≥ 32 kg/m² who enrolled in a program designed to produce 15% weight reduction over 12 weeks using total meal replacement and low- to moderate-intensity physical activity.

RESULTS:

Patients were 53 ± 7 years of age (mean ± SD) and 53% were men. After 12 weeks, BMI fell from 40.1 ± 6.6 to 35.1 ± 6.5 kg/m². HbA1c fell from 7.4% ± 1.3% to 6.5% ± 1.2% (57.4 ± 12.3 to 47.7 ± 12.9 mmol/mol) in patients with established diabetes: 76% of patients with established diabetes and 100% of patients with newly diagnosed diabetes achieved HbA1c <7.0% (53.0 mmol/mol). Improvement in HbA1c over 12 weeks was associated with higher baseline HbA1c and greater reduction in BMI.

CONCLUSIONS:

An intensive, outpatient, behavioral weight management program significantly improved HbA1c in patients with type 2 diabetes over 12 weeks. The use of such programs should be encouraged among obese patients with type 2 diabetes.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02043457.

KEYWORDS:

Obesity; Type 2 diabetes mellitus; Very-low energy diet; Weight management

PMID:
24849710
PMCID:
PMC4350259
DOI:
10.1016/j.jdiacomp.2014.03.014
[Indexed for MEDLINE]
Free PMC Article

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