A Diabetes Management Program Using Diabetes-Specific Meal Replacements and Snack Bars Improves Weight Loss, Metabolic Parameters, and Quality of Life (QOL)
Abstract Number: 2577-PO
Authors: W. TIMOTHY GARVEY, CARL J. BAUMGARTNER, JYOTIKA K. FERNANDES, MADELYN H. FERNSTROM, MAMIE J. LAUSCH, JUDY LOPER, CHARLES L. PAULE, VIKKIE A. MUSTAD.
Institutions: Birmingham, AL; Edina, MN; Charleston, SC; Pittsburgh, PA; Minneapolis, MN; Columbus, OH.
Results: While Type 2 Diabetes (T2DM) can improve with weight loss, there are few diabetes-specific approaches to help people stay motivated to manage diet and lifestyle to reduce obesity and improve complications. This study evaluated the effectiveness of diabetes-specific nutritional products in a 24 wk Diabetes Management Program. Men and women with T2DM (n=147; BMI 36±0.3, mean±SEM) enrolled into a multi-center, single-arm, unblinded study. Subjects received diet and lifestyle counseling, including two meal replacement shakes and snack bars daily. After only 12 wks, subjects (n=117) lost 4.8±0.4 kg (4.5±0.3%, P<0.001); 38% of subjects lost ≥5% initial weight. Weight loss reflected losses in subcutaneous and visceral abdominal fat area and total fat mass (p<0.01), without change in lean or bone mass. Fasting glucose decreased from 133±3 to 120±2 mg/dL, and HbA1c was reduced from 6.7±0.1% to 6.3±0.1% (p<0.001). Insulin sensitivity improved as glucose fell together with insulin (-13±3%) and C-peptide (-8±3%) (p<0.002). As a result, 24% (95% CI=16-33%) of subjects taking oral anti-diabetes medications required a reduction in dosage or number. Triglycerides decreased (-11.5±2.6%), HDL-C increased (3.0±0.9%), and modest reductions in blood pressure were observed (p<0.001). While LDL-C did not change, small LDL particles decreased and large LDL increased, with a net decrease in total LDL particle concentration and increase in mean LDL size (all p<0.001). Finally, QOL was improved in all physical and emotional categories assessed by IWQOL, (p<0.006). In summary, obese individuals with T2DM can lose weight and achieve substantial health benefits after only12 wks by using diabetes-specific meal replacements and snack bars as part of a Diabetes Management Program. The sustainability of these benefits through 24 wks is being investigated.