Restoring normoglycaemia by use of a very low calorie diet in long- and short-duration Type 2 diabetes

AimsTo establish whether an 8-week very-low-calorie diet could improve glycaemic control in Type 2 diabetes of long duration. MethodsA total of 29 people with Type 2 diabetes [short-duration group (diabetes duration <4years), n=15; long-duration group (diabetes duration >8years), n=14] completed an 8-week very-low-calorie diet, with assessments of fasting anthropometry, blood tests and blood pressure at baseline and weeks 1, 4 and 8 of the diet. ResultsSimilar weight loss was achieved in the short- and long-duration groups (14.80.8% and 14.40.7% respectively; P=0.662). The glucose response to acute calorie restriction was heterogeneous in the long-duration group with some responding similarly to those in the short-duration group, some responding, but only slowly, and others not responding at all. Overall, HbA(1c) concentration in the short- vs. long-duration groups fell to 442 vs. 646mmol/l (6.20.2 vs. 8.0 +/- 0.5%; P=0.002). Fasting plasma glucose levels decreased to 5.8 +/- 0.2 vs. 8.4 +/- 1.1mmol/l (P=0.024) respectively. A total of 87% of the short-duration group and 50% of the long-duration group achieved non-diabetic fasting plasma glucose levels at week 8. Clinically significant improvements in blood pressure and lipid profile were seen regardless of diabetes duration. ConclusionIn people with Type 2 diabetes of >8years' duration, a therapeutic trial of a very-low-calorie dietmaybe undertaken with a 50% chance of achieving non-diabetic fasting glucose levels off all antidiabetic therapies.