title: Long-term efficacy of soy-based meal replacements vs an individualized diet plan in obese type II DM patients: relative effects on weight loss, metabolic parameters, and C-reactive protein.
abstract: BACKGROUND
  Achieving significant weight loss and glycemic control in diabetic patients remains a challenging task.
  
  
  OBJECTIVE
  This study compared the effects of a soy-based meal replacement (MR) plan vs an individualized diet plan (IDP; as recommended by the American Diabetes Association) on weight loss and metabolic profile.
  
  
  METHODS
  A total of 104 subjects were randomized prospectively to the two treatments for a total of 12 months.
  
  
  RESULTS
  In all, 77 of the 104 subjects completed the study. Percentage weight loss in MR group (4.57+/-0.81%) was significantly greater (P<0.05) than in IDP group (2.25+/-0.72%). Fasting plasma glucose was significantly reduced in MR group (126.4+/-4.9 mg/dl) compared with IDP group (152.5+/-6.6 mg/dl, P<0.0001) at 6 months but not at 12 months. Controlling for baseline levels, hemoglobin Alc level improved by 0.49+/-0.22% for those receiving MR when compared to IDP group (P<0.05). A greater number of subjects in MR group reduced their use of sulfonylureas (P<0.0001) and metformin (P<0.05) as compared to IDP group. High-sensitivity C-reactive protein (hs-CRP) decreased -26.3% (P = 0.019) in MR group compared to -7.06% (P = 0.338) in IDP group at 6 months. Similar changes were observed at 12 months with MR groups, with hs-CRP decreasing by -25.0% (P = 0.019) compared to -18.7% (P = 0.179) in IDP group.
  
  
  CONCLUSIONS
  This study demonstrates that MR is a viable strategy for weight reduction in diabetic patients, resulting in beneficial changes in measures of glycemic control and reduction of medications.
authors.affiliation: David Geffen School of Medicine, Center for Human Nutrition, University of California, Los Angeles, CA 90095-1742, USA. zli@mednet.ucla.edu
authors.forename: Z
authors.initials: Z
authors.lastname: Li
authors.forename: K
authors.initials: K
authors.lastname: Hong
authors.forename: P
authors.initials: P
authors.lastname: Saltsman
authors.forename: S
authors.initials: S
authors.lastname: DeShields
authors.forename: M
authors.initials: M
authors.lastname: Bellman
authors.forename: G
authors.initials: G
authors.lastname: Thames
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
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 / Q000378:metabolism*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000178:diet therapy*; D005260:Female; D005526:Food, Formulated; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000178:diet therapy*; D011446:Prospective Studies; D045730:Soy Foods; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D008055:Lipids