Abstract
AimA very‐low‐calorie diet (VLCD) can reverse the underlying defects of type 2 diabetes mellitus (DM) in obese subjects. We determined the efficacy, safety, and durability of VLCD in Thai patients with DM and obesity.MethodsTwenty Thai patients with DM and obesity were enrolled. After a 2‐week trial, VLCD (600 kcal/day) was continued for 8 weeks, followed by a 4‐week transition period. Data on diabetes remission (fasting plasma glucose level <126 mg/dl and HbA1c <6.5% without the use of glucose‐lowering medications), glycemic control, metabolic parameters, and quality of life (QOL) were collected along with indices of insulin resistance (IR) and beta cell function. Glycemic control 12 months after discontinuation of VLCD was also examined.ResultsAmong 19 patients (age 48 ± 2 years, BMI 27.7 kg/m2) who completed the study, rapid improvement in glycemic control was observed in the first 2 weeks of VLCD. At both 8 and 12 weeks, diabetes remission was achieved in 79%. Significant weight loss was accompanied by a significant reduction in IR and an increase in beta cell function, starting at 4 weeks of VLCD. QOL also significantly increased. At 12 months after VLCD, however, DM remission was achieved in approximately 30%.ConclusionVery‐low‐calorie diet was effective and safe in inducing short‐term diabetes remission in Thai subjects by ameliorating beta cell function and IR. Optimal long‐term glycemic control was potentially durable as one‐third of subjects remained without diabetes medication 12 months after VLCD.
Highlights
Type 2 diabetes mellitus (DM) is considered a growing pandemic with a rapid increase in the number of patients in both developed and developing countries (Jayawardena et al, 2012; Nanditha et al, 2016; Yang et al, 2016)
Our study has demonstrated that caloric restriction by means of very‐low‐calorie diet (VLCD) in obese Thai patients with type 2 DM can be executed effectively and safely in an outpatient setting
A rapid improvement in glycemic control led to discontinuation of glucose‐lowering medications in all patients in the first 2 weeks
Summary
Type 2 diabetes mellitus (DM) is considered a growing pandemic with a rapid increase in the number of patients in both developed and developing countries (Jayawardena et al, 2012; Nanditha et al, 2016; Yang et al, 2016). A number of factors are thought to contribute to this pandemic, including a higher prevalence of obesity, population aging, and greater longevity due to advanced medical technologies. The global burden of DM and its complications is enormous, and effective measures to combat this disease on a large scale are clearly needed. Type 2 DM is a chronic progressive disease with deterioration of beta cell function and beta cell mass over time. Multiple modalities of treatment have been widely used for patients with type 2 DM, but most of the available therapies fail to preserve beta cell function. Insulin therapy is frequently required to maintain acceptable glycemic control
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