Decrease in Medication Usage in Type 2 Diabetics during Very-Low-Calorie and Low-Calorie Diets.

Objective: The purpose of this study was to document changes in medication usage in obese individuals with type 2 diabetes (T2D) during either a very-low-calorie diet (VLCD) or a low-calorie diet (LCD) while participating in a structured weight loss program.

Method:  Participants self selected to participate in a medically supervised weight loss program consisting of either a VLCD (n=29, age=55.6 ± 9.4, BMI=47.4 ± 10.5) or a LCD (n=16, age=56.2 ± 9.8, BMI=41.4 ± 8.5). The weight loss program consisted of structured weekly meetings and a minimum of 520 kcal/day (VLCD) or 800 kcal/day (LCD) liquid diet (Health Management Resources^TM, Boston, MA). Body weight and medication usage (oral diabetes medications, insulins, anti-hypertensives, and lipid lowering agents) were recorded at baseline, 12 wks, and when exiting the program.

Results:  Average duration of the weight loss program was 31.1 ± 15.8 wks (VLCD) and 24.8 ± 11.6 wks (LCD). For both the VLCD and the LCD groups, the change in body weight from baseline to 12 wks (-19.7 ± 7.0 kg and -16.2 ± 8.2 kg, respectively) and from baseline to exit (-33.0 ± 22.3 kg and -24.4 ± 16.2 kg, respectively) were significantly different from each other (p<0.05), but there were no significant differences between the groups (p=0.08). In the VLCD group, daily oral diabetes medication usage decreased from 1.4 ± 0.9 at baseline to 0.6 ± 0.7 at exit and total daily medications decreased from 3.7 ± 1.9 at baseline to 2.2 ± 1.6 at exit. In the LCD group, daily oral diabetes medication usage decreased from 1.1 ± 1.0 at baseline to 0.6 ± 0.9 at exit and total daily medications decreased from 4.2 ± 2.0 at baseline to 3.1 ± 1.8 at exit. At baseline, eight participants in the VLCD group were using insulin daily but at exit all but one had discontinued insulin usage.

Conclusion:  These results suggest that obese individuals with T2D can lose significant amounts of body weight and decrease medication usage while participating in a structured weight loss program that consists of either a VLCD or LCD. These results also suggest that daily insulin usage decreases in individuals with T2D while following a VLCD.