Partial meal replacement for people with type 2 diabetes: 2-year outcomes from an Australian general practice
Chee L. Khoo A B § , Ritesh Chimoriya
B § , David Simmons B C and Milan K. Piya B C *
A Healthfocus Family Practice, Ingleburn, NSW 2565, Australia.
B School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia.
C Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia.
Australian Journal of Primary Health 29(1) 74-80 https://doi.org/10.1071/PY22180
Submitted: 17 August 2022 Accepted: 7 October 2022 Published: 2 November 2022
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University
Abstract
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.
Keywords: diabetes, diabetes remission, obesity, partial meal replacement, primary care, type 2 diabetes, weight loss, weight loss maintenance.
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