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How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes
Author(s) -
Leader Natasha J.,
Ryan Lynne,
Molyneaux Lynda,
Yue Dennis K.
Publication year - 2013
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20057
Subject(s) - medicine , overweight , type 2 diabetes , meal , obesity , hypoglycemia , diabetes mellitus , weight loss , randomized controlled trial , pediatrics , endocrinology
Abstract Objective: To compare patient compliance and benefits, over 12 months, of 1 versus 2 partial meal replacement (PMR) for the management of overweight/obese subjects with inadequately controlled type 2 diabetes. Design and Methods: Thirty‐six overweight patients with inadequately controlled type 2 diabetes (BMI > 27 kg/m 2 and HbA1c > 7.5% [58 mmol/mol]) were randomized to receive 1 or 2 PMR/day, while maintaining usual lifestyle. Subjects were seen monthly and adjustment of medications was made to prevent hypoglycemia. Compliance was assessed by counting unused sachets. Results: Patients on 2 PMR/day lost almost 4 kg compared with only 0.5 kg in the 1 PMR/day group. This difference was statistically significant ( P < 0.05). Overall PMR was about 30% as effective as in our previous study on total meal replacement. Reductions in weight, waist, and HbA1c were better in the 2 PMR/day group while patient dropout and compliance were not worse over a 12‐month period. Conclusion: PMR provides a further management option for overweight/obese individuals with type 2 diabetes. The initial recommendation should be 2 PMR/day.