Very low-calorie diet in patients with longstanding type 2 diabetes mellitus: a study of real-world outcomes

Authors

  • Melanie Nana Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Sacha Moore Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Riyanath Loganathan Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Victoria Williams Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Mohammad Rahman Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Elaine Jennings Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • Anthony Dixon Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK
  • LN Rao Bondugulapati Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

DOI:

https://doi.org/10.15277/bjd.2021.316

Keywords:

very low-calorie diet (VLCD), obesity, type 2 diabetes mellitus (T2DM), weight, glycosylated haemoglobin, HbA1c

Abstract

Introduction: There is a paucity of evidence regarding the efficacy of a very low-calorie diet (VLCD) in the real-world setting. We evaluated outcomes in patients with type 2 diabetes mellitus (T2DM) who underwent VLCD.

Methods: This retrospective observational study included all patients who had undergone VLCD from 2014 to 2017 (n=61). The VLCD consisted of an eight-week 800 kcal/day dietary restriction. Metabolic parameters and medications were recorded at baseline, immediately post-VLCD and at 6 and 12 months.

Results: There was a significant reduction in weight of 9.96 kg (p<0.001) immediately post-VLCD, with net weight loss sustained to 12 months (p<0.05). There was a significant reduction in body mass index (BMI) sustained to 12 months (p<0.05). Paired HbA1c data were available for 38 patients. There was a significant reduction in HbA1c of 13.29 mmol/mol immediately post-VLCD (p<0.001), however no significant reduction was observed at 12 months (p>0.05). 78.7% patients had a reduction in T2DM medication burden post-VLCD, sustained in 44.3% of patients at 12 months. Analysis of patients with T2DM diagnosis duration >6 years demonstrated statistically significant weight loss sustained to 12 months (p<0.001).

Conclusion: Our results demonstrate sustained reduction in BMI and weight, reduction in medication burden and temporary reduction in HbA1c in patients with T2DM undertaking a VLCD in the real-world setting

Author Biographies

Melanie Nana, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Specialist Registrar in Diabetes & Endocrinology.

*Joint First Author*

Sacha Moore, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Internal Medicine Trainee.

*Joint First Author*

Riyanath Loganathan, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Foundation Year 2 Doctor.

Victoria Williams, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Dietitian

Mohammad Rahman, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Consultant in Diabetes and Endocrinology

Elaine Jennings, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Lead Dietitian

Anthony Dixon, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Consultant in Diabetes and Endocrinology

LN Rao Bondugulapati, Department of Diabetes and Endocrinology, Wrexham Maelor Hospital, Wrexham, UK

Consultant in Diabetes and Endocrinology

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Published

2021-12-17

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Original Research