Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia.
Obesity (Silver Spring). 2013 Feb;21(2):251-3. doi: 10.1002/oby.20057.
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.
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.
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.
PMR provides a further management option for overweight/obese individuals with type 2 diabetes. The initial recommendation should be 2 PMR/day.
比较 1 份与 2 份部分代餐（PMR）在超重/肥胖且 2 型糖尿病控制不佳的患者中管理超过 12 个月时的患者依从性和获益。
36 名超重且 2 型糖尿病控制不佳的患者（BMI>27kg/m²和 HbA1c>7.5%[58mmol/mol]）随机接受 1 或 2 份 PMR/天，同时保持常规生活方式。每月对患者进行随访，并调整药物以预防低血糖。通过计算未使用的小袋来评估依从性。
每天服用 2 份 PMR 的患者体重减轻了近 4kg，而每天服用 1 份 PMR 的患者仅减轻了 0.5kg。这种差异具有统计学意义（P<0.05）。总体而言，PMR 的效果约为我们之前关于全代餐研究的 30%。2 份 PMR/天组的体重、腰围和 HbA1c 降低更为显著，而在 12 个月期间，患者脱落率和依从性并没有更差。
PMR 为超重/肥胖的 2 型糖尿病患者提供了另一种管理选择。初始推荐剂量应为 2 份 PMR/天。
