Immediate and long-term effects of a very-low-calorie diet on diabetes remission and glycemic control in obese Thai patients with type 2 diabetes mellitus.
Level 4 - case-series / case-control
Uncontrolled prospective single-arm intervention study (case series design)
PubMed 30918654 · doi:10.1002/fsn3.956
What was done
Twenty Thai adults with obesity and type 2 diabetes mellitus were enrolled in an uncontrolled dietary intervention. Following a 2-week trial, participants consumed a very-low-calorie diet (VLCD, 600 kcal/day) for 8 weeks, followed by a 4-week transition period. Investigators measured diabetes remission (fasting plasma glucose <126 mg/dL and HbA1c <6.5% without glucose-lowering medications), glycemic control, metabolic parameters, quality of life (QOL), insulin resistance, and beta-cell function, with follow-up at 12 months after VLCD discontinuation.
What was found
Among 19 patients (mean age 48 ± 2 years, mean BMI 27.7 kg/m²) who completed the study, rapid improvement in glycemic control occurred within the first 2 weeks. Diabetes remission was achieved in 79% of patients at both 8 and 12 weeks, accompanied by significant weight loss, decreased insulin resistance, improved beta-cell function starting at 4 weeks, and increased QOL. At 12 months post-VLCD, diabetes remission was maintained in approximately 30% of subjects. Exact numerical values for weight loss, HbA1c, fasting glucose, and QOL were not reported in the abstract.
Why it matters
This study shows that severe caloric restriction can induce short-term diabetes remission and improve beta-cell function in an Asian cohort with modest baseline obesity (BMI ~28 kg/m²), though efficacy declines substantially by 12 months.
Limits
The study is limited by a very small sample size (n=19 completers) and the absence of a control group. The abstract omits precise quantitative values and confidence intervals for weight, glycemic metrics, and insulin sensitivity, and does not report adherence rates or predictors of 12-month remission maintenance.
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