Liquid Meal Replacements and Glycemic Control in Obese Type 2 Diabetes Patients

Yip I, Liang V, DeShields S, Saltsman P, Bell Ballman M, Thames G, Murray S, Wang H, Elashoff R, Heber D. Obesity Research. 2001;9:341S-347S.

Objective

To evaluate the safety and efficacy of meal replacements for weight loss in obese patients with type 2 diabetes.

Methods

A 12-week weight loss study was undertaken with 75 subjects with type 2 diabetes. These subjects were taking oral hypoglycemic drugs to control their disease and were randomly assigned to 1 of 3 dietary treatments: a traditional exchange diet (TED) (control); or 1 of 2 meal replacement (MR, Slim·Fast®) groups in which 1 group used MR containing added fructose and sucrose (MR+S) and the other group used MR without added sugars (MR-S). All subjects met with a registered dietitian at baseline, and at 2, 4, 8, and 12 weeks.

Results

A total of 57 subjects completed the weight loss phase. No significant differences were seen between the 2 MR groups for both primary and secondary measures, hence these data were pooled and compared to the control group (n=41 MR, n=16 control). The combined MR group lost significantly greater amounts of weight (6.1 ± 4.4 kg vs 4.2 ± 4.7 kg; P=0.009) by the end of the study. At 12 weeks, serum glucose concentration was significantly lower in the MR group (P=0.012) when compared with the control group, whereas insulin and HbA1c were comparably and significantly reduced in both treatment groups (P<0.05). Total cholesterol and LDL cholesterol levels were significantly improved in the MR group (P<0.05).

Other Key Findings

In a separate study, 16 subjects from the above study group were selected to evaluate the glucose and insulin responses after consumption of a single meal composed of either a breakfast of traditional foods or a single MR+S shake (with added sugars) in a crossover design.

Measurement of the area under the curve (AUC) for blood glucose and insulin, as well as the individual time points, demonstrated that the administration of a single acute dose of MR compared to a meal of traditional foods was not different. Therefore, a MR+S, containing a mixture of added sugars (fructose and sucrose), was not shown to alter the glycemic response in subjects with type 2 diabetes.

Conclusion

Liquid meal replacements are an effective and safe method of weight loss for obese patients with type 2 diabetes. Significant improvements were observed in body weight, glucose, insulin, HbA1c, and lipid levels.

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