The study included 22 obese type 2 diabetic patients taking more than 100 units of insulin per day….
Patients had 3 main meals with 50 grams of energy-restricted, protein-rich diet meal replacement (PRMR) (Almased-Vitalkost) each (=4903 kJ day-1) for the first week. In week 2 to 4, breakfast and dinner were replaced. In week 5 to 12, only dinner was replaced. Clinical assessments were at baseline, 4 weeks, 8 weeks, 12 weeks continued for 1.5 years. The Wilcoxon signed-rank test was used for the intention-to-treat analysis since only 15 patients completed the study. The Mann-Whitney U-test was used for subgroup analyses.
The results from 15 out of 22 patients have shown lower mean insulin dose required from 147 units to 65 units (p<0.0001); HbA1c decreased from 8.8% to 8.1%(p=0.048) and weight decrease from 118 kg to 107.4kg (p<0.0001). Furthermore, body mass index, fasting body glucose, waist and hip circumferences improved significantly. After 1.5 years, HbA1c, weight, and insulin dose were further reduced for patients who continued energy-restricted PRMR.
PRMR has shown improvement in insulin therapy, HbA1c, and body composition. Glycemic control can be improved in long term with continuous use of PRMR. Energy restricted, protein-rich diet meal replacement may be considered as a new therapeutic option to help tighter glycemic control and reduce insulin dose.
Kempf K, Schloot NC, Gärtner B,et al. Meal replacement reduces insulin requirement, HbA1c and weight long-term in type 2 diabetes patients with >100 U insulin per day. J Hum Nutr Diet. 2013 Aug 2