Restoring normoglycaemia by use of a very low calorie diet in long‐ and short‐duration Type 2 diabetes

Aims To establish whether an 8‐week very‐low‐calorie diet could improve glycaemic control in Type 2 diabetes of long duration. Methods A total of 29 people with Type 2 diabetes [short‐duration group (diabetes duration < 4 years), n  =   15; long‐duration group (diabetes duration > 8 years), n  =   14] completed an 8‐week very‐low‐calorie diet, with assessments of fasting anthropometry, blood tests and blood pressure at baseline and weeks 1, 4 and 8 of the diet. Results Similar weight loss was achieved in the short‐ and long‐duration groups (14.8 ± 0.8% and 14.4 ± 0.7% respectively; P  =   0.662). The glucose response to acute calorie restriction was heterogeneous in the long‐duration group with some responding similarly to those in the short‐duration group, some responding, but only slowly, and others not responding at all. Overall, HbA 1c concentration in the short‐ vs. long‐duration groups fell to 44 ± 2 vs. 64 ± 6 mmol/l (6.2 ± 0.2 vs. 8.0 ± 0.5%; P  =   0.002). Fasting plasma glucose levels decreased to 5.8 ± 0.2 vs. 8.4 ± 1.1 mmol/l ( P  =   0.024) respectively. A total of 87% of the short‐duration group and 50% of the long‐duration group achieved non‐diabetic fasting plasma glucose levels at week 8. Clinically significant improvements in blood pressure and lipid profile were seen regardless of diabetes duration. Conclusion In people with Type 2 diabetes of > 8 years' duration, a therapeutic trial of a very‐low‐calorie diet may be undertaken with a 50% chance of achieving non‐diabetic fasting glucose levels off all antidiabetic therapies.