Effects of meal replacement therapy on metabolic outcomes in Thai patients with type 2 diabetes: A randomized controlled trial

• Published in: Nutrition and health (Berkhamsted) 2018-12, Vol.24 (4), p.261-268
• Main Authors: Boonyavarakul, Apussanee, Leelawattana, Rattana, Pongchaiyakul, Chatlert, Buranapin, Supawan, Phanachet, Pariya, Pramyothin, Pornpoj
• Format: Article
• Language: English
• Subjects: Beverages; Blood Glucose - metabolism; Body Mass Index; Body Weight; Diabetes Mellitus, Type 2 - diet therapy; Diabetes Mellitus, Type 2 - metabolism; Diet - methods; Female; Glycated Hemoglobin A - metabolism; Glycemic Index; Humans; Lipids - blood; Male; Meals; Middle Aged; Thailand; Waist Circumference
• ISSN: 0260-1060; 2047-945X
• DOI: 10.1177/0260106018800074

Background: A meal replacement (MR) with a low glycemic index (GI) is possibly beneficial for glycemic control. However, the effects of MR on diabetes mellitus have not been studied among Thai patients with type 2 diabetes (T2DM). Aim: To compare metabolic outcomes between T2DM patients receiving the new MR formula (ONCE PRO) and normal controlled diets. Methods: A multicenter, open-labeled, randomized controlled trial was conducted. Eligible patients received either ONCE PRO for one meal daily with controlled diets or only controlled diets for 3 months. The differences in metabolic profile between the baseline and end point of each group and between groups were measured. Results: 110 participants were enrolled; the mean difference and standard deviation in hemoglobin A1C (HbA1c) (%) from baseline were –0.21 ± 0.78 (p = 0.060) and –0.27 ± 0.60 (p = 0.001) in the MR and control groups, respectively; however, there was no significant difference between groups (p = 0.637). Patients consuming a MR instead of breakfast had a significant decrease in HbA1c (p = 0.040). Body weight (BW) and body mass index (BMI) were significantly reduced in both groups. There were no significant change in waist circumference, fasting plasma glucose, total cholesterol and triglycerides. Low-density lipoprotein cholesterol (LDL-C) was significantly decreased in the MR group compared with the control group (p = 0.049). Conclusions: Short-term conventional diet control and the low-GI MR product were associated with a decreased BW and BMI. Changes in the other metabolic outcomes, HbA1c, total cholesterol and triglycerides, were comparable despite ONCE PRO as the MR having a better effect on LDL-C lowering.