Eating to stop diabetes

2020 ◽  
Vol 12 (549) ◽  
pp. eabc8952
Author(s):  
Priyathama Vellanki

Very low-calorie diets can induce and sustain significant weight loss and diabetes remission.

2019 ◽  
Vol 3 (s1) ◽  
pp. 137-137
Author(s):  
Kim Qumby ◽  
Colette George ◽  
Ian Hambleton ◽  
Patrick Olivier ◽  
Nigel Unwin

OBJECTIVES/SPECIFIC AIMS: The aim is to investigate if sustained weight loss due to caloric restriction can be achieved in a community setting, using faith-based organisations (FBOs) as hubs; and if this weight loss can lead to the re-establishment of normal metabolism (using the normalisation of blood sugar levels while off glucose lowering medication as a proxy) in a person with pre-diabetes or T2DM. METHODS/STUDY POPULATION: Members of the FBO with either a diagnosis of T2DM for <6 years or pre-diabetes as defined by the American Diabetes Association (ADA); and a Body Mass index (BMI) of ≥27 kg/m2 are eligible. After counselling, participants will be placed on a 12 week low calorie liquid diet, supplemented by low carbohydrate vegetables, totalling approximately 840 kcal/day. During this time, participants will be monitored weekly at their FBO by trained members of their congregation, with oversight from the study team, for change in weight, fasting blood glucose, waist and hip circumference and blood pressure. This will be followed by a 3 month period during which participants will receive ongoing dietary advice as they transfer to a balanced, reduced calorie, solid diet. Physical measurements will be monitored monthly during this 3 month period. The next 6 months is a period where the participants and the FBO health team move towards ‘independence’. This involves further training of the FBO health team and participants in healthy lifestyle habits; and a commitment by the leadership of the FBO to assume ‘ownership’ for NCD monitoring within their community. Physical measurements will be repeated at the end of one year. RESULTS/ANTICIPATED RESULTS: Based on previous studies, we expect that participants who are compliant to the diet will lose approximately 2.2 kg per week over the 12 week period. This will be associated with rapid (within 1 week) normalisation of fasting blood glucose levels (<7mmol / L). We expect that, due to the accessibility of NCD monitoring and support, that participants to be satisfied with their care and compliant to their regime and that the results of the first 12 weeks will be sustained at the 12 month follow up. We expect that the FBO leadership will assume the responsibility of continuing and NCD programme, not only for the local congregation but for the surrounding community. DISCUSSION/SIGNIFICANCE OF IMPACT: Diabetes remission with a low calorie diet is a viable intervention for T2DM remission however social support is key to an individual’s success. This novel study which proposes institution of a diabetes remission intervention which fits into the participant’s locale and involves peer support, should increase long-term success.


2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Kim R. Quimby ◽  
Natasha Sobers ◽  
Colette George ◽  
Natalie Greaves ◽  
Francine Browman-Jones ◽  
...  

Abstract Objectives The aims of this feasibility study were to (1) examine the implementation of a community-based health advocate (CHA) training programme to develop the clinical skills needed to support a diabetes remission protocol based on a low-calorie diet (LCD) and (2) investigate if participant weight loss can be achieved and diabetes remission induced under these conditions. Methods This tripartite study followed a type 2 implementation-effectiveness design. Three faith-based organisations (FBOs) were purposively selected as study sites. Implementation outcomes were guided by the Consolidated Framework for Implementation Research. During the pre-implementation phase, site ‘readiness’ to facilitate the intervention was determined from a site visit and an interview with the FBOs’ leadership. During the implementation phase, congregants could volunteer for the 10-week CHA training which included practical exercises in weight, glucose and blood pressure (BP) measurement, and a summative practical assessment. Acceptability and implementation effectiveness were assessed via survey. During the intervention phase, other congregants and community members with T2DM or pre-diabetes and overweight were invited to participate in the 12-week LCD. Anti-diabetic medication was discontinued on day 1 of the intervention. Clinical effectiveness was determined from the change in weight, fasting blood glucose (FBG) and BP which were monitored weekly at the FBO by the CHA. HbA1C was performed at weeks 1 and 12. Results The FBOs were found to be ready as determined by their adequate resources and engagement in health-related matters. Twenty-nine CHAs completed the training; all attained a passing grade at ≥1 clinical station, indicating implementation effectiveness. CHA feedback indicated that the programme structure was acceptable and provided sufficient access to intervention-related material. Thirty-one persons participated in the LCD (11 T2DM:20 pre-diabetes). Mean (95%CI) weight loss was 6.0 kg (3.7 to 8.2), 7.9 kg in males vs 5.7 kg in females; A1C (%) decreased from 6.6 to 6.1, with a greater reduction in those with T2DM when compared to pre-diabetes. FBG decreased from 6.4 to 6.0mmol/L. T2DM remission rates were 60% and 90% by A1C<6.5% and FBG<7mmol/L respectively. Pre-diabetes remission was 18% and 40% by A1C<5.7% and FBG<5.6 respectively. Conclusion Implementation of a community-based diabetes remission protocol is both feasible and clinically effective. Its sustainability is to be determined. Adaptability to other disorders or other settings should be investigated. Trial registration NCT03536377 registered on 24 May 2018.


1992 ◽  
Vol 56 (1) ◽  
pp. 182S-184S ◽  
Author(s):  
P M Suratt ◽  
R F McTier ◽  
L J Findley ◽  
S L Pohl ◽  
S C Wilhoit

2000 ◽  
Vol 93 (5) ◽  
pp. 254-257 ◽  
Author(s):  
John Miles ◽  
Catherine Petrie ◽  
Michael Steel

Summary The first 50 websites identified on searching the Internet for ‘weight loss diets’ were assessed systematically and their content compared with published clinical guidelines for management of obesity. The relevance and quality of the sites varied enormously. Only 3 confined themselves to sound dietary advice. Most promoted dietary supplements or other ‘slimming aids’, often of uncertain composition and based on dubious physiological principles. Potential hazards—for example, those of very low calorie diets—were rarely highlighted and certain regimens on offer were potentially dangerous.


2020 ◽  
Author(s):  
Marleen M. Romeijn ◽  
Aniek M. Kolen ◽  
Daniëlle D. B. Holthuijsen ◽  
Loes Janssen ◽  
Goof Schep ◽  
...  

Abstract An energy-restricted diet is often prescribed before bariatric surgery to reduce weight and liver volume. While very-low-calorie diets (VLCDs, 450–800 kcal per day) have shown to be effective, the effectiveness of low-calorie diets (LCDs, 800–1500 kcal per day) is less obvious. The objective of this systematic review was to elucidate the effectiveness of LCD on liver volume reduction in patients awaiting bariatric surgery. Eight studies (n = 251) were included describing nine different diets (800–1200 kcal, 2–8 weeks). An LCD was effective in liver volume reduction (12–27%) and weight loss (4–17%), particularly during the first weeks. The LCD showed an acceptable patients’ compliance. Based on these findings, an LCD (800–1200 kcal), instead of a VLCD, for 2 to 4 weeks should be preferred.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2086
Author(s):  
Susan Juray ◽  
Kathleen V. Axen ◽  
Steven E. Trasino

Very low-calorie diets (VLCD) are hypocaloric dietary regimens of approximately 400–800 kcal/day that result in 20–30% reductions in body weight, sometimes in just 12–16 weeks. A body of evidence demonstrates that adherence to VLCD in adults with type 2 diabetes (T2D) can result in marked improvements to glycemic control and even full T2D remission, challenging the convention that T2D is a lifelong disease. Although these data are promising, the majority of VLCD studies have focused on weight loss and not T2D remission as a primary endpoint. Moreover, there is a wide range of VLCD protocols and definitions of T2D remission used across these hypocaloric studies. Together the large degree of heterogeneity in VLCD studies, and how T2D remission is defined, leave many gaps in knowledge to efficacy and durability of VLCD approaches for T2D remission. This narrative review examines findings from a body of data from VLCD studies that specifically sought to investigate T2D remission, and discusses the efficacy of VLCD compared to other hypocaloric approaches, and who is likely to benefit from VLCD approaches for T2D remission.


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