The safety and efficacy of a low-energy diet to induce weight loss, improve metabolic health, and induce diabetes remission in insulin-treated obese men with type 2 diabetes: a pilot RCT
Open accessAbstract
Data are sparse on the safety and efficacy of commercially available energy-restricted meal plans in obese subjects with type 2 diabetes mellitus (T2DM). This study examined the safety and efficacy of a commercially available low-energy diet in insulin-treated obese men with type 2 diabetes. Eighteen men ≥ 35 years old who had class III obesity, had received insulin treatment for ≥ 1 year for type 2 diabetes, and had glycated hemoglobin (Hb) ≥ 6.5% were randomized to receive either a low-energy diet ( N = 9) or standard medical nutrition intervention ( N = 9) for 6 months. Compared with 1.5% (± 3.55) in the control group, the mean percentage weight loss in the intervention group at 6 months was 9.6% (±4.91) ( p < 0.01). Complete and partial diabetes remission occurred in one subject each in the intervention group and no subjects in the control group. Mean glycated Hb levels were 8.9% (± 2.76) and 9.1% (± 1.53) ( p = NS) at baseline and 6.5% (± 0.64) and 7.4% (± 1.12) ( p = 0.0606) at 6 months for the intervention and control groups, respectively. Compared with 0.85 mmol/L at baseline, the mean high-density lipoprotein cholesterol (HDL-C) level in the intervention group at 6 months increased to 0.96 mmol/L ( p < 0.01) while it remained unchanged in the control group. Among obese men with insulin-treated type 2 diabetes, compared with standard medical nutrition, 6 months of a low-energy diet resulted in complete diabetes remission in one subject and partial remission in another while improving diabetes control and decreasing the median daily dose of insulin in the remainder.
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Five studies compared diet interventions with usual care according to clinical guidelines, without providing foods or dietary products for participants.
“Five studies compared diet interventions with usual care according to clinical guidelines, without providing foods or dietary products for participants [49–53].”
Among these five studies, three provided diabetes education or advice.
“Among these, three provided diabetes education or advice (Table 2) [49, 50, 52].”
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Type 2 Diabetes Remission and Role of Technology
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- Authors
- Mollentze, W. F., Joubert, G., Prins, A., van der Linde, S., Marx, G. M., & Tsie, K. G.
- Affiliations
- University of the Free State (ZA)
- Corresponding author
- Mollentze, Willem Frederik
- Venue
- International Journal of Diabetes in Developing Countries
- Published
- 2019-03-22
- Volume
- 39
- Issue
- 4
- Pages
- 618-625
- ISSN
- 0973-3930 (ISSN-L)
- 1998-3832
- OpenAlex
- W2927398699
- Cited by
- 11
- References
- 24
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 2
- FWCI
- 1.02
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Diabetes in Developing Countries (publishedVersion, cc-by)
- Funders
- Mr. Christo Strydom, CSN Nutrition (CSN001-13)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- type 2 diabetes, obesity, hypocaloric diet, caloric restriction, weight loss, diabetes remission, insulin-treated diabetes, HbA1c, HDL cholesterol, metabolic health, medical nutrition therapy, insulin dose reduction
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