The very-low-calorie-diets: which contribution to the management of obese type 2 diabetic patients?

It is well-recognized that standard caloric restrictions (1500 kcal/day) ar e usually poorly effective in achieving weight losses in overweight type 2 diabetic patients. For that reason very-low-calorie-diets (VLCDs) were deve loped as a mean for initiating or accelerating weight reduction. Short-term studies indicate that VLCDs result generally in weight losses that are thr ee times greater than those obtained with standard low-calorie-diets. Fasti ng blood glucose values are improving in parallel to weight tosses and in m any patients the improvement in glycemic control is better than that expect ed from the magnitude of weight losses. However the results are rather disa ppointing after several months or years of follow-up. For example it has be en demonstrated that weight regain can be observed as soon as the patient i s shifted to a refeeding or maintenance dietary program at the end of the V LCD period. Long-term results on glycemic control and body weight reduction are generally similar with standard low-calorie-diets and with VLCDs, the final results depending on the magnitude of weight loss whatever the prescr ibed diet. Al shortterm the VLCDs can be helpful first for initiating weigh t losses and second for sensitizing the patient to the potential benefits o f complying to dietary measures.