Lew Leong Chen, Mat Ludin Arimi Fitri, Abdul Manaf Zahara, Mohd Tohit Noorlaili, Shahar Suzana
Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Kuala Lumpur, Malaysia.
Biomedical Science Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Kuala Lumpur, Malaysia.
World J Diabetes. 2025 Aug 15;16(8):104371. doi: 10.4239/wjd.v16.i8.104371.
Type 2 diabetes (T2D) is a major health concern globally and its prevalence is expected to continue to escalate. Lifestyle intervention is an integral part of T2D management. Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs. There are various trials being carried out to date; however, a thorough review regarding the usage of meal replacement on its types, dosage and associated outcomes and adverse events is still lacking.
To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D, and map out glycemic and weight-related outcomes along with adverse effects incidences.
This scoping review is conducted based on Arksey and O'Malley's seminal framework for scoping reviews. A systematic search has been done for studies published between January 2020 and January 2024 across six online databases (Cochrane Library, PubMed, Science Direct, Scopus, Web of Science and Ebscohost Discovery) using specific keywords. Two researchers independently assessed the eligibility of the studies and extracted the data. The selected articles and extracted data were reviewed by all researchers.
The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening. Included studies were categorized based on meal replacement type into low calorie/energy, low glycemic index, protein-rich, low-fat, diabetes-specific formulas, and combined lifestyle intervention programs. Fifty-nine studies reported improvements on hemoglobin A1c, and 70 studies reported positive changes in weight or BMI after the meal replacement intervention. The combination of meal replacements with education, counseling or structured lifestyle interventions has proved to be effective. Only 13 studies reported occurrence of adverse events related to the intervention. Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.
The results suggest that meal replacements, especially when combined with lifestyle intervention programs and counseling, are an effective and safe strategy in glycemic and weight management among patients with T2D.
2型糖尿病（T2D）是全球主要的健康问题，其患病率预计将持续上升。生活方式干预是T2D管理的重要组成部分。代餐通常被用作T2D生活方式干预计划和体重管理计划的一部分。迄今为止，正在进行各种试验；然而，关于代餐的类型、剂量以及相关结果和不良事件的使用情况仍缺乏全面的综述。
全面概述关于T2D患者使用代餐的现有研究，并梳理血糖和体重相关结果以及不良反应发生率。
本范围综述基于Arksey和O'Malley的范围综述开创性框架进行。使用特定关键词对2020年1月至2024年1月期间在六个在线数据库（Cochrane图书馆、PubMed、科学Direct、Scopus、科学网和Ebscohost发现）上发表的研究进行了系统检索。两名研究人员独立评估研究的 eligibility，并提取数据。所有研究人员对所选文章和提取的数据进行了审查。
初步检索共得到53922篇文章，经过资格筛选后，本综述纳入了133篇文章。纳入的研究根据代餐类型分为低热量/能量、低血糖指数、富含蛋白质、低脂、糖尿病专用配方以及联合生活方式干预计划。59项研究报告了糖化血红蛋白有所改善，70项研究报告了代餐干预后体重或体重指数有积极变化。代餐与教育、咨询或结构化生活方式干预相结合已被证明是有效的。只有13项研究报告了与干预相关的不良事件发生。报告的大多数事件为轻度事件，便秘是报告最多的不良事件。
结果表明，代餐，尤其是与生活方式干预计划和咨询相结合时，是T2D患者血糖和体重管理的有效且安全的策略。
