title: Liquid meal replacements and glycemic control in obese type 2 diabetes patients.
abstract: OBJECTIVE
  Although weight management is an important component in the treatment of type 2 diabetes, there has been concern about the use of liquid meal replacements (MRs) in treating obese patients with type 2 diabetes because of the sugar content of the MRs. The goal of this study was to evaluate the safety and feasibility of using MRs for weight loss in obese patients with type 2 diabetes.
  
  
  METHODS
  Seventy-five subjects with type 2 diabetes, treated only with oral agents, were recruited for this 12-week clinical study. Subjects were randomized into three groups using either a MR containing lactose, fructose, and sucrose, a MR in which fructose and sucrose were replaced with oligosaccharides (sugar-free Slim-Fast), or an exchange diet plan (EDP) using the proportion of macronutrients recommended by the American Diabetes Association.
  
  
  RESULTS
  Fifty-seven patients (41 MR and 16 EDP) finished the study. None developed serious adverse effects, including major hypoglycemic reactions. Weight losses in the MR 1 and MR 2 groups were comparable (6.4% and 6.7%, respectively) and greater than the weight loss in the EDP group (4.9%). Fasting glucose level was significantly reduced in the MR group compared with the EDP group (p = 0.012). There was a significant reduction in the MR group in total cholesterol and low-density lipoprotein cholesterol that was not seen in the EDP group.
  
  
  CONCLUSIONS
  We have shown that liquid MRs are a safe and effective weight loss tool for obese subjects with type 2 diabetes, and can result in improvements in body weight, glucose, insulin, hemoglobin A1c and lipid levels.
authors.affiliation: Center for Human Nutrition, University of California, Los Angeles School of Medicine, Los Angeles, California 90095-1742, USA.
authors.forename: I
authors.initials: I
authors.lastname: Yip
authors.forename: V L
authors.initials: VL
authors.lastname: Go
authors.forename: S
authors.initials: S
authors.lastname: DeShields
authors.forename: P
authors.initials: P
authors.lastname: Saltsman
authors.forename: M
authors.initials: M
authors.lastname: Bellman
authors.forename: G
authors.initials: G
authors.lastname: Thames
authors.forename: S
authors.initials: S
authors.lastname: Murray
authors.forename: H J
authors.initials: HJ
authors.lastname: Wang
authors.forename: R
authors.initials: R
authors.lastname: Elashoff
authors.forename: D
authors.initials: D
authors.lastname: Heber
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003920:Diabetes Mellitus / Q000178:diet therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000178:diet therapy*; D005215:Fasting; D005526:Food, Formulated; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D009765:Obesity; D012996:Solutions; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D007328:Insulin; D012996:Solutions