Partial meal replacement for people with type 2 diabetes: 2-year outcomes from an Australian general practice.

Abstract

This study aimed to determine weight loss and improvement in glycaemia at 12 and 24months in patients with type 2 diabetes mellitus (T2DM), following a 3-month partial meal replacement and subsequent reduced calorie diet. This was a retrospective cohort study of patients with T2DM attending a solo general practice in Sydney, New South Wales, Australia. Participants were advised to follow a 3-month partial meal replacement plan comprising of two meal replacement shakes plus a healthy meal. Over the subsequent 21months, patients were encouraged to follow a reduced calorie diet with a particular emphasis on lowering carbohydrate intake. Of the 153 patients with T2DM, 51 (33.3%) agreed to follow a 3-month partial meal replacement plan, which was completed by 66.7% (n =34/51). Compared to baseline, the average weight loss at 12 and 24months was 7.1±7.0kg (102.2±20.9kg vs 95.1±18.7kg, P <0.001) and 4.2±7.7kg (102.2±20.9kg vs 98.0±18.2kg, P =0.003), respectively. Haemoglobin A1c (HbA1c) was significantly reduced at 12months (6.9±1.5% vs 6.3±0.9%, P =0.003), but not at 24months. The proportion of participants that met the criteria for diabetes remission was similar at baseline (8.8%) and 12months (11.8%), but increased to 32.4% at 24months (P =0.016). Patients with T2DM who were able to follow a partial meal replacement plan for 3months with advice from a general practitioner achieved significant weight loss over 24months. A multicentre randomised controlled trial to confirm these findings is required as this could significantly change the management of T2DM in primary care.