Meal Replacements for Weight-Related Complications in Type 2 Diabetes: What Is the State of the Evidence?

Effect of Total and Partial Meal Replacements on Factors Related to Glucose Metabolism: A Systematic Review and Meta-analysis of Randomized Controlled Trials

CONTEXT

Although some evidence shows the beneficial effects of meal replacements (MRs) on glucose metabolism as one of the main factors of diabetes, there are still no comprehensive findings in this field.

OBJECTIVE

We investigated the effects of total and partial MRs on fasting blood sugar (FBS), insulin, glycated hemoglobin (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in this comprehensive study and meta-analysis.

DATA SOURCES

To find pertinent randomized controlled trials (RCTs) up to March 2024, databases including PubMed/Medline, Web of Science, Scopus, and Embase were searched.

DATA EXTRACTION

This study included all RCTs investigating the effects of MRs on factors related to glucose metabolism. The pooled weighted mean difference (WMD) and 95% CIs were computed using the random-effects model.

DATA ANALYSIS

The findings from 52 studies indicated significant reductions in FBS (WMD: -3.10 mg/dL; 95% CI: -4.99, -1.20; P < .001), insulin (WMD: -1.79 μU/mL; 95% CI: -3.51, -0.08; P = .40), HOMA-IR (WMD: -0.86; 95% CI: -1.68, -0.04; P = .040), and HbA1c (WMD: -0.24%; 95% CI: -0.35%, -0.13%; P < .001) levels following MR consumption compared with the control group. The findings obtained from the subgroup analysis showed that MRs cause a greater decrease in FBS, insulin, and HOMA-IR in the >50-years age group compared with those aged ≤50 years and also during interventions ≤24 weeks compared with >24 weeks.

CONCLUSION

In conclusion, it appears that MRs, along with other lifestyle factors, can lead to significant improvements in glucose metabolism.

Effect of meal replacements formula on lipid profiles: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Although some evidence shows the beneficial effects of meal replacements (MRs) on dyslipidaemias, it is not completely clear. Therefore, we investigate the possible effects of total and partial MRs on lipid profiles.

METHODS

For this systematic review and meta-analysis, we searched MEDLINE, Web of Science, SCOPUS, and Embase. We included randomized controlled trials (RCTs) that evaluated the effect of MRs on lipid profiles. A random-effects meta-analysis model was used to combine studies and calculate weighted mean difference and 95 % confidence intervals (95 % CI). Subgroup analysis was realized using intervention type, duration and average participant age.

RESULTS

Fifty-one studies were included. The pooled findings showed that total and partial MRs significantly reduced triglycerides (TG) (WMD: -12.20 mg/dl, 95 % CI -17.46 to -6.93) and increased high-density lipoprotein (HDL) (WMD: 1.06 mg/dl, 95 % CI 0.35-1.77) compared to controls. However, total cholesterol (TC) (WMD: -1.40 mg/dl, 95 % CI: -3.90-1.10) and low-density lipoprotein (LDL) (WMD: -0.85 mg/dl, 95 % CI: -3.05-1.35) were not significant. In addition, the subgroup analysis shows a greater effect on TG reduction and HDL increase in the type of intervention with total MRs compared to partial MRs and during the intervention >24 weeks compared to ≤24 weeks.

CONCLUSIONS

MRs lead to significant improvements in TG and HDL levels. These results may help strengthen programs for dyslipidaemias prevention/management.

Diabetes-specific formula with standard of care improves glycemic control, body composition, and cardiometabolic risk factors in overweight and obese adults with type 2 diabetes: results from a randomized controlled trial

Background and aims

Medical nutrition therapy is important for diabetes management. This randomized controlled trial investigated the effects of a diabetes-specific formula (DSF) on glycemic control and cardiometabolic risk factors in adults with type 2 diabetes (T2D).

Methods

Participants (n = 235) were randomized to either DSF with standard of care (SOC) (DSF group; n = 117) or SOC only (control group; n = 118). The DSF group consumed one or two DSF servings daily as meal replacement or partial meal replacement. The assessments were done at baseline, on day 45, and on day 90.

Results

There were significant reductions in glycated hemoglobin (-0.44% vs. -0.26%, p = 0.015, at day 45; -0.50% vs. -0.21%, p = 0.002, at day 90) and fasting blood glucose (-0.14 mmol/L vs. +0.32 mmol/L, p = 0.036, at day 90), as well as twofold greater weight loss (-1.30 kg vs. -0.61 kg, p  < 0.001, at day 45; -1.74 kg vs. -0.76 kg, p < 0.001, at day 90) in the DSF group compared with the control group. The decrease in percent body fat and increase in percent fat-free mass at day 90 in the DSF group were almost twice that of the control group (1.44% vs. 0.79%, p = 0.047). In addition, the percent change in visceral adipose tissue at day 90 in the DSF group was several-fold lower than in the control group (-6.52% vs. -0.95%, p < 0.001). The DSF group also showed smaller waist and hip circumferences, and lower diastolic blood pressure than the control group (all overall p ≤ 0.045).

Conclusion

DSF with SOC yielded significantly greater improvements than only SOC in glycemic control, body composition, and cardiometabolic risk factors in adults with T2D.