George Alleyne Chronic Disease Research Centre, Caribbean Institute for Health Research, University of the West Indies, Barbados.
MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Diabet Med. 2020 Nov;37(11):1816-1824. doi: 10.1111/dme.14096. Epub 2019 Aug 12.
In a high proportion of people with recently diagnosed Type 2 diabetes, a short (2-3-month) low-calorie diet is able to restore normal glucose and insulin metabolism. The aim of this study was to determine the feasibility of this approach in Barbados.
Twenty-five individuals with Type 2 diabetes diagnosed within past 6 years, not on insulin, BMI ≥ 27 kg/m were recruited. Hypoglycaemic medication was stopped on commencement of the 8-week liquid (760 calorie) diet. Insulin response was assessed in meal tests at baseline, 8 weeks and 8 months. Semi-structured interviews, analysed thematically, explored participants' experiences. 'Responders' were those with fasting plasma glucose (FPG) < 7 mmol/l at 8 weeks.
Ten men and 15 women (mean age 48, range 26-68 years) participated. Mean (sd) BMI was 34.2 kg/m (6.0); FPG 9.2 mmol/l (2.2). Mean weight loss at 8 weeks and 8 months was 10.1 kg [95% confidence interval (CI) 8.1, 12.0] and 8.2 kg (95% CI 5.8, 10.6); FPG was lower by 2.2 mmol/l (95% CI 1.2, 3.2) and 1.7 mmol/l (95% CI 0.8, 2.7) respectively. Nine of 11 (82%) of those who lost ≥ 10 kg were 'responders' compared with 6 of 14 (43%) who lost < 10 kg (P = 0.048). The 30-min insulin increment was higher in responders at baseline and follow-up (P ≤ 0.01). A food culture based on starchy foods and pressures to eat large amounts at social events were among the challenges identified by participants.
The feasibility of this approach to weight loss and diabetes remission in a predominantly black population in Barbados was demonstrated.
在很大比例的新近诊断为 2 型糖尿病的人群中，短期（2-3 个月）低热量饮食能够恢复正常的葡萄糖和胰岛素代谢。本研究的目的是确定这种方法在巴巴多斯的可行性。
招募了 25 名在过去 6 年内被诊断为 2 型糖尿病、未使用胰岛素、BMI≥27kg/m2 的患者。在开始为期 8 周的液体（760 卡路里）饮食时停止使用降血糖药物。在基线、8 周和 8 个月时进行餐食试验评估胰岛素反应。通过半结构化访谈，以主题分析的方式，探讨参与者的经验。“应答者”是指在 8 周时空腹血糖（FPG）<7mmol/l 的患者。
10 名男性和 15 名女性（平均年龄 48 岁，范围 26-68 岁）参与了研究。平均（标准差）BMI 为 34.2kg/m2（6.0）；FPG 9.2mmol/l（2.2）。8 周和 8 个月时的平均体重减轻量分别为 10.1kg（95%置信区间（CI）8.1，12.0）和 8.2kg（95%CI 5.8，10.6）；FPG 分别降低了 2.2mmol/l（95%CI 1.2，3.2）和 1.7mmol/l（95%CI 0.8，2.7）。11 名体重减轻≥10kg 的患者中，有 9 名（82%）为“应答者”，而 14 名体重减轻<10kg 的患者中，有 6 名（43%）为“应答者”（P=0.048）。在基线和随访时，应答者的 30 分钟胰岛素增量更高（P≤0.01）。参与者确定的挑战包括以淀粉类食物为基础的饮食文化以及在社交活动中大量进食的压力。
在巴巴多斯以黑人为主要人口的情况下，这种减肥和糖尿病缓解方法是可行的。
