Very low-calorie diet in patients with longstanding type 2 diabetes mellitus: a study of real-world outcomes

Introduction: There is a paucity of evidence regarding the efficacy of a very low-calorie diet (VLCD) in the real-world setting. We evaluated outcomes in patients with type 2 diabetes mellitus (T2DM) who underwent VLCD. Methods: This retrospective observational study included all patients who had undergone VLCD from 2014 to 2017 (n=61). The VLCD consisted of an eight-week 800 kcal/day dietary restriction. Metabolic parameters and medications were recorded at baseline, immediately post-VLCD and at 6 and 12 months. Results: There was a significant reduction in weight of 9.96 kg (p<0.001) immediately post-VLCD, with net weight loss sustained to 12 months (p<0.05). There was a significant reduction in body mass index (BMI) sustained to 12 months (p<0.05). Paired HbA1c data were available for 38 patients. There was a significant reduction in HbA1c of 13.29 mmol/mol immediately post-VLCD (p<0.001), however no significant reduction was observed at 12 months (p>0.05). 78.7% patients had a reduction in T2DM medication burden post-VLCD, sustained in 44.3% of patients at 12 months. Analysis of patients with T2DM diagnosis duration >6 years demonstrated statistically significant weight loss sustained to 12 months (p<0.001). Conclusion: Our results demonstrate sustained reduction in BMI and weight, reduction in medication burden and temporary reduction in HbA1c in patients with T2DM undertaking a VLCD in the real-world setting

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Very low calorie diet (VLCD) in obese patients with longstanding type 2 diabetes mellitus: real-world outcomes with twelve months follow-up

Endocrine Abstracts ◽

10.1530/endoabs.65.p180 ◽

2019 ◽

Author(s):

Melanie Nana ◽

Sacha Moore ◽

Ria Loganathan ◽

Victoria Williams ◽

Mohammad Rahman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Real World ◽

Obese Patients ◽

Very Low Calorie Diet ◽

Low Calorie Diet ◽

Calorie Diet

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Serum Concentrations and Subcutaneous Adipose Tissue mRNA Expression of Omentin in Morbid Obesity and Type 2 Diabetes Mellitus: the Effect of Very-Low-Calorie Diet, Physical Activity and Laparoscopic Sleeve Gastrectomy

Physiological Research ◽

10.33549/physiolres.932530 ◽

2014 ◽

pp. 207-218 ◽

Cited By ~ 7

Author(s):

M. URBANOVÁ ◽

I. DOSTÁLOVÁ ◽

P. TRACHTA ◽

J. DRÁPALOVÁ ◽

P. KAVÁLKOVÁ ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mrna Expression ◽

Subcutaneous Adipose Tissue ◽

Very Low Calorie Diet ◽

Low Calorie Diet ◽

Calorie Diet ◽

Subcutaneous Adipose

Omentin is a novel adipokine with insulin-sensitizing effects expressed predominantly in visceral fat. We investigated serum omentin levels and its mRNA expression in subcutaneous adipose tissue (SCAT) of 11 women with type 2 diabetes mellitus (T2DM), 37 obese non-diabetic women (OB) and 26 healthy lean women (C) before and after various weight loss interventions: 2-week very-low-calorie diet (VLCD), 3-month regular exercise and laparoscopic sleeve gastrectomy (LSG). At baseline, both T2DM and OB groups had decreased serum omentin concentrations compared with C group while omentin mRNA expression in SCAT did not significantly differ among the groups. Neither VLCD nor exercise significantly affected serum omentin concentrations and its mRNA expression in SCAT of OB or T2DM group. LSG significantly increased serum omentin levels in OB group. In contrast, omentin mRNA expression in SCAT was significantly reduced after LSG. Baseline fasting serum omentin levels in a combined group of the studied subjects (C, OB, T2DM) negatively correlated with BMI, CRP, insulin, LDL-cholesterol, triglycerides and leptin and were positively related to HDL-cholesterol. Reduced circulating omentin levels could play a role in the etiopathogenesis of obesity and T2DM. The increase in circulating omentin levels and the decrease in omentin mRNA expression in SCAT of obese women after LSG might contribute to surgery-induced metabolic improvements and sustained reduction of body weight.

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Increased serum concentrations of macrophage inhibitory cytokine-1 in patients with obesity and type 2 diabetes mellitus: the influence of very low calorie diet

Acta Endocrinologica ◽

10.1530/eje-09-0417 ◽

2009 ◽

Vol 161 (3) ◽

pp. 397-404 ◽

Cited By ~ 69

Author(s):

Ivana Dostálová ◽

Tomáš Roubíček ◽

Markéta Bártlová ◽

Miloš Mráz ◽

Zdena Lacinová ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Mrna Expression ◽

Obese Women ◽

Very Low Calorie Diet ◽

Low Calorie ◽

Low Calorie Diet ◽

Calorie Diet

ObjectiveMacrophage inhibitory cytokine-1 (MIC-1) is a novel regulator of energy homeostasis. We explored whether alterations in MIC-1 levels contribute to metabolic disturbances in patients with obesity and/or obesity and type 2 diabetes mellitus (T2DM).DesignWe measured serum MIC-1 levels and its mRNA expression in subcutaneous and visceral adipose tissue of 17 obese nondiabetic women, 14 obese women with T2DM and 23 healthy lean women. We also explored the relationship of MIC-1 with anthropometric and biochemical parameters and studied the influence of 2-week very low calorie diet (VLCD) on serum MIC-1 levels.MethodsSerum MIC-1 levels were measured by ELISA and its mRNA expression was determined by RT-PCR.ResultsBoth obese and T2DM group had significantly elevated serum MIC-1 levels relative to controls. T2DM group had significantly higher serum MIC-1 levels relative to obese group. Serum MIC-1 positively correlated with body weight, body fat, and serum levels of triglycerides, glucose, HbAlc, and C-reactive protein and it was inversely related to serum high-density lipoprotein cholesterol. Fat mRNA MIC-1 expression did not significantly differ between lean and obese women but it was significantly higher in subcutaneous than in visceral fat in both groups. VLCD significantly increased serum MIC-1 levels in obese but not T2DM group.ConclusionElevated MIC-1 levels in patients with obesity are further increased by the presence of T2DM. We suggest that in contrast to patients with cancer cachexia, increased MIC-1 levels in obese patients and diabetic patients do not induce weight loss.

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The Effect of Very-Low-Calorie Diet on mRNA Expression of Inflammation-Related Genes in Subcutaneous Adipose Tissue and Peripheral Monocytes of Obese Patients with Type 2 Diabetes Mellitus

Endocrinology ◽

10.1210/endo.152.3.zee1193 ◽

2011 ◽

Vol 152 (3) ◽

pp. 1193-1193 ◽

Cited By ~ 5

Author(s):

M. Mraz ◽

Z. Lacinova ◽

J. Drapalova ◽

D. Haluzikova ◽

A. Horinek ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Subcutaneous Adipose Tissue ◽

Obese Patients ◽

Very Low Calorie Diet ◽

Low Calorie Diet ◽

Calorie Diet ◽

Subcutaneous Adipose

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Serum Concentrations of Fibroblast Growth Factor 19 in Patients With Obesity and Type 2 Diabetes Mellitus: the Influence of Acute Hyperinsulinemia, Very-Low Calorie Diet and PPAR-α Agonist Treatment

Physiological Research ◽

10.33549/physiolres.932099 ◽

2011 ◽

pp. 627-636 ◽

Cited By ~ 34

Author(s):

M. MRÁZ ◽

Z. LACINOVÁ ◽

P. KAVÁLKOVÁ ◽

D. HALUZÍKOVÁ ◽

P. TRACHTA ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Fibroblast Growth ◽

Serum Concentrations ◽

Very Low Calorie Diet ◽

Low Calorie Diet ◽

Calorie Diet ◽

Fibroblast Growth Factor 19

The aim of our study was to measure serum concentrations of fibroblast growth factor 19 (FGF-19) in patients with obesity (OB), obesity and type 2 diabetes mellitus (T2DM) and healthy subjects (C) at baseline and after selected interventions. We measured serum FGF-19 levels and other biochemical and hormonal parameters in 29 OB and 19 T2DM females and 30 sex- and age-matched control subjects. The interventions were acute hyperinsulinemia during isoglycemic-hyperinsulinemic clamp (n=11 for T2DM and 10 for C), very-low calorie diet (VLCD, n=12 for OB) and 3 months treatment with PPAR-α agonist fenofibrate (n=11 for T2DM). Baseline serum FGF-19 levels were significantly lower in OB relative to C group (132.1±12.7 vs. 202.2±16.7 pg/ml, p<0.05), while no significant difference was observed between T2DM and OB or control group. Acute hyperinsulinemia tended to decrease FGF-19 levels in both healthy and T2DM subjects. Three weeks of VLCD in OB group had no significant effect on FGF-19, whereas three months of fenofibrate treatment markedly reduced FGF-19 levels in T2DM patients (194.58±26.2 vs. 107.47±25.0 pg/ml, p<0.05). We conclude that FGF-19 levels in our study were at least partially dependent upon nutritional status, but were not related to parameters of glucose metabolism or insulin sensitivity.

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