Liquid meal replacements and glycemic control in obese type 2 diabetes patients

Objective: Although weight management is an important component in the trea tment of type 2 diabetes, there has been concern about the use of liquid me al replacements (MRs) in treating obese patients with type 2 diabetes becau se of the sugar content of the MRS. The goal of this study was to evaluate the safety and feasibility of using MRS for weight loss in obese patients w ith type 2 diabetes. Research Methods and Procedures: Seventy-five subjects with type 2 diabetes , treated only with oral agents, were recruited for this 12-week clinical s tudy. Subjects were randomized into three groups using either a MR containi ng lactose, fructose, and sucrose, a MR in which fructose and sucrose were replaced with oligosaccharides (sugar-free Slim-Fast), or an exchange diet plan (EDP) using the proportion of macronutrients recommended by the Americ an Diabetes Association. Results: Fifty-seven patients (41 MR and 16 EDP) finished the study. None d eveloped serious adverse effects, including major hypoglycemic reactions. W eight losses in the MR I and MR 2 groups were comparable (6.4% and 6.7%, re spectively) and greater than the weight loss in the EDP group (4.9%). Fasti ng glucose level was significantly reduced in the MR group compared with th e EDP group (p = 0.012). There was a significant reduction in the MR group C in total cholesterol and low-density lipoprotein cholesterol that was not seen in the EDP group. Discussion: We have shown that liquid MRS are a safe and effective weight l oss tool for obese subjects with type 2 diabetes, and can result in improve ments in body weight, glucose, insulin, hemoglobin Alc and lipid levels.