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Which diet is best for treating type 2 diabetes?

Thursday 18 November 2021 12:09pm

Professor Mike Lean (University of Glasgow and adjunct Professor of Medicine, University of Otago), Dr Andrew Reynolds (Department of Medicine, University of Otago), and international colleagues have published a study in the journal Diabetologia showing that low energy diets with formula meal replacements are the most effective method for weight management and remission of type 2 diabetes.

This new study systematically reviewed all the relevant publications of diet trial meta-analyses for weight management in people with type 2 diabetes. They also considered all studies which have reported remission of type 2 diabetes.

The authors found that the greatest weight loss was achieved with very low energy formula diets. Formula meal replacements were also found to be superior to food-based low-energy diets alone, achieving 2.4kg greater weight loss over 12-52 weeks.

The published evidence shows that low-carbohydrate diets were no better than higher carbohydrate (low-fat) diets for weight loss. The authors concluded:

“Published meta-analyses of diets for weight management in people with type 2 diabetes do not support recommending any particular macronutrient profile or style over others. Very low energy diets and formula meal replacement appear the most effective approaches, generally providing less energy than self-administered food-based diets.”

The ability of type 2 diabetes to be put into remission using very low energy formula diets has been something of a revolution in the treatment of this disease.  Previously only bariatric surgery had been reported to achieve similar outcomes. Both approaches do require on-going dietary and lifestyle changes to maintain this remission.

However, the finding that a range of diets are suitable for weight loss in those living with type 2 diabetes gives more choice for clinicians and patients, says Dr Reynolds:

"I think that this research gives us great freedom to work with patients to find weight loss diet that are sustainable and work for them, so long as it is low in energy and meets the requirements for nutrients such as protein and fibre."

Read more about the study