Effective Weight Management Method for Adults With Type 2 Diabetes

The development of T2D involves a complex interaction of gut hormones, low-grade inflammation, and possibly metabolites from the gut microbiota.

It develops in susceptible individuals and families who tend to have large waists and who accumulate fat in their liver, pancreas, and muscles. This impairs organ functions, resulting in abnormally high blood sugar, high blood pressure, and abnormal blood fats.

Almost 80% of people with T2D for up to 6 years who lost over 10kg, and maintained the weight loss of over 10 kg, remained in remission from diabetes for at least 2 years.

While there is widespread awareness of the benefits of weight loss for people withT2D, there is a lack of authoritative guidance over dietary advice, to inform both patients and healthcare providers.

Current guidelines stress the importance of personalized weight management and state that various diet strategies may be effective but do not provide information about diet composition. This can lead to patients following diets based on distorted evidence and misleading claims.

Adherence to any energy-reduced diet will lead to sustained weight loss, provided that energy (calorie) use exceeds intake.

However, in practice, adherence rates and weight losses vary widely, even within the same diet program, and some comparisons between diets appear to show conflicting results.

To resolve these uncertainties, researchers analyzed published meta-analyses of which type of diet is best for achieving and then maintaining weight loss in adults with T2D.

Their analysis found that the greatest weight loss was achieved with very low energy formula diets, used as ‘Total Diet Replacement’ at 1.7-2.1 MJ/day [400-500 kcal/day] for 8-12 weeks, which led to an average 6.6kg more weight lost compared to food-based low-energy diets (4.2-6.3 MJ/day [1000-1500 kcal/day]).

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Formula meal replacements were also found to be superior to food-based low-energy diets alone, achieving 2.4kg greater weight loss over 12-52 weeks.

For remission of T2D, published studies showed the best remission rates of 46-61% at 12 months with programs that include a formula ‘Total Diet Replacement’ of 830 kcal/day for 12 weeks, followed by a relatively low-fat high carbohydrate diet and meal replacements for long-term maintenance.

With low carbohydrate diets, reported remission rates are much lower at 4%-19% of those who tried the diet.

Published meta-analyses of diets for weight management in people with type 2 diabetes do not support recommending any particular macronutrient profile or style over others.

Very low energy diets and formula meal replacement appear the most effective approaches, generally providing less energy than self-administered food-based diets.

A limitation of the trials examined by this study is that the benefits from weight management depend largely on long-term control of body weight, while most of the currently available evidence relates only to short-term outcomes.

Well-conducted research is needed to assess longer-term impacts on weight, blood sugar control, clinical outcomes, and diabetes complications.

Source: Medindia