scholarly journals The Effect Of Diet Composition On Weight Gain in Obese, Type 2 Diabetes Patients Receiving Intensive Insulin Therapy

2015 ◽  
Vol 6 (2) ◽  
pp. 111-116
Author(s):  
Roland Villareal

This study was conducted to contribute to the limiting existing body of literature about diet and prevention of weight gain when administering intensive insulin therapy.  The effects of a high- monounsaturated fatty acid (MUFA) diet compared with a conventional diabetic diet have not been studied in insulin treated patients.  A growing body of evidence assessed that diets rich in high-MUFA foods had similar glycemic results, as do low-fat, high carbohydrate diets.  However, a high-MUFA diet did not raise triglycerides as suspected.  Ros (2003) stated that high-MUFA energy controlled diets do not promote weight gain and are more acceptable for weight loss and/or maintenance. A MUFA diet can be used as an alternate to the conventional American Diabetic Association (ADA) diet when managing obese type 2 diabetes patients treated with intensive insulin therapy.  Dietary restriction to 1600 calories in diabetes patients on intensive insulin therapy decreased the A1C value by 1.3 points in the ADA group and 1.5 points in the MUFA group without weight gain and without additional insulin required.  In conclusion the total calorie count was more important for preventing weight gain and reducing the A1C in patients on intensive insulin therapy than was dietary composition.

2019 ◽  
Vol 25 (9) ◽  
pp. 899-907 ◽  
Author(s):  
Alexandra Emery ◽  
Chang Ye ◽  
Haysook Choi ◽  
Caroline K. Kramer ◽  
Bernard Zinman ◽  
...  

Objective: In early type 2 diabetes (T2DM), the administration of short-term intensive insulin therapy (IIT) can induce glycemic remission for a year thereafter, but this effect ultimately wanes. In this context, intermittently repeating short-term IIT could provide a strategy for maintaining the otherwise transient benefits of this intervention. However, the viability of this strategy would be contingent upon not inducing undesirable effects of insulin therapy such as excessive hypoglycemia and fat deposition. We thus sought to evaluate the effect of administering short-term IIT every 3 months on hypoglycemia, weight gain, and quality of life in early T2DM. Methods: In this 2-year pilot trial, 24 adults with T2DM of 2.0 ± 1.7 years duration and hemoglobin A1c of 6.4 (46 mmol/mol) ± 0.1% were randomized to 3 weeks of IIT (glargine, lispro) followed by either ( 1), repeat IIT for up to 2 weeks every 3 months or ( 2), daily metformin. IIT was titrated to target near-normoglycemia (premeal glucose 4 to 6 mmol/L; 2-hour postmeal <8 mmol/L). Participants were assessed every 3 months, with quality of life (QOL) evaluated annually. Results: The rate of hypoglycemia (<3.5 mmol/L) was low in the metformin and intermittent IIT arms (0.37 versus 0.95 events per patient-year; P = .28). There were no differences between the groups in changes over time in overall, central, or hepatic fat deposition (as reflected by weight [ P = .10], waist-to-hip ratio [ P = .58], and alanine aminotransferase [ P = .64], respectively). Moreover, there were no differences between the groups in QOL at 1- and 2-years. Conclusion: Intermittent short-term IIT may be safely administered in early T2DM without excessive adverse impact on hypoglycemic risk, anthropometry, or QOL. Abbreviations: ALT = alanine aminotransferase; HbA1c = hemoglobin A1c; IIT = intensive insulin therapy; ISSI-2 = insulin secretion-sensitivity index-2; OGTT = oral glucose tolerance test; QOL = quality of life; SF-36 = medical outcomes study 36-item short-form health survey; T2DM = type 2 diabetes


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