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A 12-Week Low-Calorie Diet plus Behavioral Modification Acutely Improves Glycemic Parameters in Type 2 Diabetes Mellitus

Bobbie G Paull Forney, Justin B Moore, Frank Dong, Elizabeth Ablah and James L Early

Background: This study sought to determine the effect of a 12-week low-calorie diet (LCD) and behavioral modification program on fasting plasma glucose (FPG) levels, glycated hemoglobin (GHb) levels, use of hypoglycemic agents, and change in glycemic parameters in an overweight or obese population with type 2 diabetes mellitus. Methods: This was a retrospective review of 129 participants with type 2 diabetes. Logistic regression analysis was conducted to explore predictors associated with improvement in glycemic parameters. Results: FPG decreased from 7.77 ± 2.62 mmol/l at baseline to 6.66 ± 1.93 mmol/l after 12 weeks (p=0.0013). GHb decreased from 7.34 ± 1.38% at baseline to 6.55 ± 0.95% after 12 weeks (p<0.001). Use of hypoglycemic agents decreased from 1.69 ± 1.09 hypoglycemic agents per patient at baseline to 1.01 ± 0.93 hypoglycemic agents per patient after 12 weeks (p<0.005). The prevalence of optimal glycemic parameters, defined as a GHb under 6.5% and an FPG under 7.0 mmol/l while off medications, increased from 1.4% (n=1 of 71) at baseline to 23.9% (n=17 of 71) after 12 weeks. Males were more likely to achieve optimal glycemic parameters at 12 weeks than were females (OR 3.7, 95% CI [1.2, 11.8]). Participants with a baseline GHb ≤ 7.0% were more likely than those with a GHb>7.0% to achieve optimal glycemic parameters after 12 weeks (OR 4.6, 95% CI [1.4,15.7]). Conclusions: A 12-week low-calorie diet combined with a behavioral modification program is effective in reducing FPG, GHb, and use of hypoglycemic agents and it is associated with acute improvement in glycemic parameters in obese subjects with type 2 diabetes mellitus.mechanisms controlling skeletal muscle mass to that of the lean, while reducing body mass.