Aim: Intermittent very-low-calorie diet (VLCD) provides more flexibility than continuous VLCD to optimize individual results. This study was designed to determine the effects of Intermittent VLCD (2 or 4 days/week) on glycemic control, metabolic parameters and quality of life (QoL) in patients with type 2 diabetes and obesity.

Method: 40 participants (mean age 49.6 ± 7.9 years, BMI 30.1 ± 5.9 kg/m2, mean diabetes duration 4.7 ± 3.1 years, mean HbA1C 7.4 ± 1.2%) were enrolled. Participants were randomly assigned 1:1:1 into 3 groups [control (n=12), 2 days/week VLCD (n=14), or 4 days/week VLCD (n=14)]. In the Intermittent VLCD groups, participants received 600 kcal/day in restricted days (2 and 4 non-consecutive days/week) and ad libitum food consumption on non-restricted days for 20 weeks. Metabolic parameters and QoL were evaluated at baseline, 2nd, 10th and 20th week.

Results: There was improvement in glycemic control in both intermittent VLCD groups throughout the study period. At the end of study, an intention-to-treat analysis showed that the mean reduction (± SEM) of FPG level was 7.9 (± 13.5), 25.1 (± 12.5) and 39.7 (± 12.5) mg/dl, and HbA1C level was 0.1(± 1.3), 0.7 (± 0.3) and 1.2 (± 0.3) % in the control group, the 2 days/week VLCD group and the 4 days/week VLCD group, respectively. There were no significant differences in the reduction in FPG or HbA1c between the 2 days/week and 4 days/week VLCD groups. The mean difference (± SEM) of FPG level between both groups was 11 mg/dl (95% CI, -17.5 - 39.5 mg/dl) and the mean difference (± SEM) of HbA1C level between both groups was 0.39% (95% CI, -3.3 - 1.1%). Intermittent VLCD was associated with marked improvement in insulin sensitivity and beta-cell function, as reflected in HOMA-IR, Matsuda, Disposition, and Insulinogenic indices. QoL was significantly increased in all groups.

Conclusion: Intermittent VLCD, 2 days/week or 4 days/week, was equally comparable and effective in achieving glycemic control.

Disclosure

M. Umphonsathien: None. P. Rattanasian: None. W. Suansawang: None. S. Lokattachariya: None. W. Khovidhunkit: None.

Funding

National Research Council of Thailand; Health Systems Research Institute

© 2019 by the American Diabetes Association.
2019
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