Short‐term results of an open trial of very low calorie diet or intensive conventional diet in Type 2 diabetes

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AbstractAn assessment of short‐term feasibility, safety and efficacy of intensive conventional diet with life‐style advice (ICD) and very low calorie diet (VLCD) has been conducted in obese Type 2 diabetic subjects and obese non‐diabetic patients. The study will continue for three years and comprises 19 non‐diabetic subjects on VLCD, 14 diabetic subjects on VLCD, and 14 diabetic subjects on ICD.At three months both VLCD groups showed significant reductions in weight, BMI, waist measurement, waist/hip ratio, serum cholesterol and triglycerides and serum fructosamine, even though antidiabetic and hypolipidaemic treatments had been discontinued. All the patients had returned to a low fat conventional diet by six months, at which time weight losses were maintained at 11 kg for the diabetic and 21 kg for the non‐diabetic groups. Waist and waist/hip ratio remained significantly improved in the diabetic group, though median systolic and diastolic blood pressures, serum fructosamine, cholesterol and triglycerides were less than at baseline but not significantly so.In the non‐diabetic VLCD group, waist, systolic and diastolic blood pressures, serum cholesterol and triglycerides but not waist/hip ratio were all significantly less at six months compared with baseline.The ICD diabetic group showed significant reductions only in weight (2kg) and BMI (1 unit) at three months, though by six months there was a weight loss of a median of 3kg and a significant fall of 11 mmHg in diastolic blood pressure.One severe hypoglycaemic attack occurred in a diabetic on VLCD and one myocardial infarction in a diabetic in the ICD group.This analysis of the acute phase of the study shows favourable results, and such interventions could readily be incorporated into hospital or primary healthcare diabetes programmes. Long‐term studies of large groups of Type 2 diabetic patients will be required in order to assess effects on outcome.