Partial meal replacement for people with type 2 diabetes : 2-year outcomes from an Australian general practice

Background. This study aimed to determine weight loss and improvement in glycaemia at 12 and 24 months in patients with type 2 diabetes mellitus (T2DM), following a 3-month partial meal replacement and subsequent reduced calorie diet. Methods. This was a retrospective cohort study of patients with T2DM attending a solo general practice in Sydney, New South Wales, Australia. Participants were advised to follow a 3-month partial meal replacement plan comprising of two meal replacement shakes plus a healthy meal. Over the subsequent 21 months, patients were encouraged to follow a reduced calorie diet with a particular emphasis on lowering carbohydrate intake. Results. Of the 153 patients with T2DM, 51 (33.3%) agreed to follow a 3-month partial meal replacement plan, which was completed by 66.7% (n = 34/51). Compared to baseline, the average weight loss at 12 and 24 months was 7.1 +/- 7.0 kg (102.2 +/- 20.9 kg vs 95.1 +/- 18.7 kg, P < 0.001) and 4.2 +/- 7.7 kg (102.2 +/- 20.9 kg vs 98.0 +/- 18.2 kg, P = 0.003), respectively. Haemoglobin A1c (HbA1c) was significantly reduced at 12 months (6.9 +/- 1.5% vs 6.3 +/- 0.9%, P = 0.003), but not at 24 months. The proportion of participants that met the criteria for diabetes remission was similar at baseline (8.8%) and 12 months (11.8%), but increased to 32.4% at 24 months (P = 0.016). Conclusions. Patients with T2DM who were able to follow a partial meal replacement plan for 3 months with advice from a general practitioner achieved significant weight loss over 24 months. A multicentre randomised controlled trial to confirm these findings is required as this could significantly change the management of T2DM in primary care.