Weight loss for individuals with type 2 diabetes following a very-low-calorie diet in a community-based setting with trained facilitators for 12 weeks

Authors


Address for correspondence: Dr C Rolland, Centre for Obesity Research and Epidemiology, Robert Gordon University, Aberdeen AB25 1HG, UK. E-mails: c.rolland@rgu.ac.uk, ext.rolland1@rgu.ac.uk

Summary

What is already known about this subject

  • Approximately 80% of people with type 2 diabetes mellitus (T2DM) are overweight or obese.
  • Weight loss produces numerous benefits in T2DM.
  • People with T2DM have difficulty losing and maintaining weight.

What this study adds

  • Provision of a very-low-calorie diet (VLCD) with group support and behaviour therapy for patients with T2DM is feasible within a community-based setting with trained facilitators.
  • VLCD approaches for weight management in T2DM can achieve more than 90% of weight loss as compared with obese individuals without T2DM.
  • Identification of the need to investigate the full impact of this approach in patients with T2DM by assessing changes in glycaemia, liver function and medication.

Approximately 80% of people with type 2 diabetes mellitus (T2DM) are overweight or obese, and obesity compounds the cardiovascular risk of T2DM. The aim of this retrospective study was twofold: first, to investigate whether a 12-week community-based very-low-calorie diet (VLCD) programme can result in important weight loss; and second, to investigate any potential difference in the weight loss achieved using this community-based approach in individuals with and without T2DM. Three hundred and fifty-five participants with T2DM were matched for age, body mass index (BMI) and gender to participants without T2DM (total cohort comprised 204 males: 506 females (mean ± standard deviation); age (years) 54.0 ± 9.1; BMI (kg m−2) 41.6 ± 8.1; weight (kg) 116.1 ± 25.1). The programme included a daily intake of 550 kcal in addition to group support and behaviour therapy provided by trained facilitators within a community-based setting. After 12 weeks, there was significant weight loss within each group when compared with baseline (T2DM: 115.0 ± 24.4 kg vs. 96.7 ± 21.4 kg, P < 0.0001; non-T2DM: 117.2 ± 25.8 kg vs. 97.3 ± 22.2 kg, P < 0.0001). At 12 weeks, weight change (−18.3 ± 7.3 kg vs. −19.9 ± 7.0 kg, P = 0.012) and BMI change (−6.7 ± 2.9 kg m−2 vs. −7.1 ± 2.1 kg m−2, P = 0.011) were significantly less in the T2DM group when compared with the non-T2DM group. Our results suggest that the use of VLCD approaches for weight management in T2DM can achieve more than 90% of the weight loss seen in obese individuals without T2DM.

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