Meal replacements for weight loss in type 2 diabetes in a community setting

Background. there is limited information on the effectiveness of meal replacements (mrs) as a weight-loss strategy in an unsupervised community setting. aim. to evaluate the use of mr compared with a diet book for 6 months. subjects and methods. obese subjects (n = 120) with type 2 diabetes mellitus were recruited from the community in adelaide,south australia,and randomised to intervention or control. subjects in the intervention were advised to consume 2 mr/day for 3 months and 1 mr/day for 3 months and follow the manufacturers' instructions from printed material and the website. subjects in the control arm were given a commercially available diet book. results. consumption of 2 mr for 3 months and 1 mr for the subsequent 3 months led to weight loss of 5.5 kg (5%) and a 0.26% decrease in hba1c while the diet book group had a weight loss of 3 kg (3%) (p = 0.027 for difference between groups) and a decrease in hba1c of 0.15% (between group ns) in those who completed the 6-month study. on intention-to-treat (last observation carried forward) weight loss at 6 months was 3.4 kg in mr and 1.8 kg in control (p = 0.07). decreases in hba1c were 0.22% and 0.12%,respectively (p = ns). hdl cholesterol increased by 4% in mr and decreased by 1% in control (p = 0.004). blood pressure decreased equally in both groups. there were reductions in fasting glucose in both groups at 6 months with no changes in ldl-cholesterol or triglyceride concentrations. conclusion. mr confers benefits in hba1c reduction and weight loss at 6 months in those who completed the study. © 2012 jennifer b. keogh and peter m. clifton.