Very-low-calorie diet-based intensive lifestyle intervention for remission of type 2 diabetes: Real-world experience in a South Asian population

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-08-08 DOI:10.1111/dme.15422

H. A. Dissanayake, D. R. Fernando, A. I. Nilaweera, T. D. Munasinghe, C. M. A. U. Kaushalya, M. M. Pulukkody, P. Katulanda

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引用次数: 0

Abstract

Aims

Very low-calorie diet (VLCD) can induce weight loss and diabetes remission (DR) amongst people with obesity and recent-onset type 2 diabetes (T2D). We aimed to determine the effectiveness and acceptability of VLCD in achieving DR amongst Sri Lankan adults with T2D.

Methods

A retrospective analysis was conducted in a diabetes practice where VLCD-based Diabetes Remission Programme (VDRP) was offered for adults (>18 years) with T2D for <3 years and body mass index over 25 kg/m². VLCD (~800 kcal/day, provided with/without diet replacement formula) was offered for 8–12 weeks, followed by gradual food reintroduction and exercise. DR was defined as HbA1c <6.5% at least 3 months after stopping glucose-lowering medications.

Results

A total of 170 participants who enrolled in the VDRP (mean age 38.4 years [±11.1], men 68%, mean baseline HbA1c 86.9 [±18.1] mmol/mol (10.1 [±2.1]%), median duration of T2D 2 years [IQR 1–2]) and 87 (51%) of them followed the programme (attended at least one follow-up visit). Amongst the individuals who followed the VDRP, 40.2% achieved DR (35/87), compared with 2.4% (2/83) amongst those who did not follow the VDRP (aHR 9.3, 95% CI 2.2–16.4, p = 0.002). The proportion achieving normoglycaemia (HbA1c < 6.5%) but continued to take glucose-lowering medication was 20/87 among VDRP followers and 20/85 amongst VDRP non-followers. The commonest reasons for not following the VDRP were too restrictive dietary quantity (92%) and difficulties in finding recommended food items (67%). Majority (79%) would recommend VDRP to others.

Conclusions

VDRP is effective in achieving T2D remission amongst Sri Lankan adults with recently diagnosed T2D and obesity. Over half of the participants followed the programme and over 75% would recommend it to others, indicating good acceptability.

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基于极低热量饮食的强化生活方式干预，缓解 2 型糖尿病：南亚人群的实际经验。

目的：超低卡路里饮食（VLCD）可促使肥胖和新近发病的 2 型糖尿病（T2D）患者减轻体重和缓解糖尿病（DR）。我们旨在确定 VLCD 在斯里兰卡成年 2 型糖尿病患者中实现糖尿病缓解的有效性和可接受性：方法：我们在一家糖尿病诊所进行了一项回顾性分析，该诊所为患有 T2D 的成年人（18 岁以上）提供了基于 VLCD 的糖尿病缓解计划（VDRP），为期 2 年。提供的 VLCD（约 800 千卡/天，提供/不提供饮食替代配方）为期 8-12 周，随后逐步重新引入食物并进行锻炼。DR 的定义是 HbA1c 结果：共有 170 人参加了 VDRP（平均年龄为 38.4 岁 [±11.1]，男性占 68%，平均基线 HbA1c 为 86.9 [±18.1] mmol/mol（10.1 [±2.1] %），T2D 中位持续时间为 2 年 [IQR 1-2]），其中 87 人（51%）参加了该计划（至少参加了一次随访）。在实施 VDRP 的患者中，40.2% 的患者（35/87）实现了 DR，而在未实施 VDRP 的患者中，只有 2.4% 的患者（2/83）实现了 DR（aHR 9.3，95% CI 2.2-16.4，p = 0.002）。达到正常血糖水平的比例（HbA1c在新近确诊患有 T2D 和肥胖症的斯里兰卡成年人中，VDRP 可有效缓解 T2D。超过半数的参与者参与了该计划，超过 75% 的参与者会向他人推荐该计划，这表明该计划具有良好的可接受性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”