title: How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes.
abstract: OBJECTIVE
  To compare patient compliance and benefits, over 12 months, of 1 versus 2 partial meal replacement (PMR) for the management of overweight/obese subjects with inadequately controlled type 2 diabetes.
  
  
  METHODS
  Thirty-six overweight patients with inadequately controlled type 2 diabetes (BMI > 27 kg/m(2) and HbA1c > 7.5% [58 mmol/mol]) were randomized to receive 1 or 2 PMR/day, while maintaining usual lifestyle. Subjects were seen monthly and adjustment of medications was made to prevent hypoglycemia. Compliance was assessed by counting unused sachets.
  
  
  RESULTS
  Patients on 2 PMR/day lost almost 4 kg compared with only 0.5 kg in the 1 PMR/day group. This difference was statistically significant (P < 0.05). Overall PMR was about 30% as effective as in our previous study on total meal replacement. Reductions in weight, waist, and HbA1c were better in the 2 PMR/day group while patient dropout and compliance were not worse over a 12-month period.
  
  
  CONCLUSIONS
  PMR provides a further management option for overweight/obese individuals with type 2 diabetes. The initial recommendation should be 2 PMR/day.
authors: Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia. natashajoleader@gmail.com
authors: Natasha J
authors: NJ
authors: Leader
authors: Lynne
authors: L
authors: Ryan
authors: Lynda
authors: L
authors: Molyneaux
authors: Dennis K
authors: DK
authors: Yue
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008019:Life Style; D008297:Male; D062407:Meals; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D050177:Overweight / Q000150:complications / Q000178:diet therapy*; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin