Background: Glycemic variability (GV) has been demonstrated to contribute to the development of diabetic complications. The current study sought to investigate the effect of partial meal replacement (PMR) on GV in type 2 diabetes.
Methods: 123 individuals with newly diagnosed and untreated type 2 diabetes were randomized to receive either lifestyle intervention (LI) together with breakfast replacement with a liquid formula (LI+PMR, n=62) or LI alone (n=61) for 4 weeks. All participants underwent continuous glucose monitoring (CGM) for 72 hours both before and after intervention. GV metrics obtained from CGM included the incremental area under the curve of postprandial blood glucose (AUCpp), standard deviation of blood glucose (SDBG), glucose coefficient of variation (CV), and mean amplitude of glycaemic excursions (MAGE).
Results: At the end of the study, patients in LI+PMR exhibited more pronounced improvements in systolic blood pressure (P=0.046) and time in range (P=0.033) than those in LI. More importantly, LI+PMR led to significantly greater improvements in all GV metrics including SDBG (P=0.005), CV (P=0.002), MAGE (P=0.016) and AUCpp (P<0.001) than did LI. In addition, multiple regression analysis revealed that LI+PMR (vs. LI) was independently associated with the improvements in GV after adjusting for covariates (all P<0.05).
Conclusion: Our study showed that LI+PMR resulted in significantly greater improvements in GV than did LI, suggesting that LI+PMR could be an effective treatment to alleviate glucose excursions.
J. Zhou: None. J. Lu: None. X. Ma: None. J. Peng: None. L. Ying: None. W. Lu: None. W. Zhu: None. Y. Bao: None.
Shanghai Municipal Education Commission; Gaofeng Clinical Medicine Grant (20161430)