Very-low-calorie diet: A quick therapeutic tool to improve β cell function in morbidly obese patients with type 2 diabetes

Ilaria Malandrucco, Patrizio Pasqualetti, Ilaria Giordani, Dario Manfellotto, Federica De Marco, Filippo Alegiani, Anna Maria Sidoti, Fabiana Picconi, Alessandra Di Flaviani, Gaetano Frajese, Riccardo C. Bonadonna, Simona Frontoni

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Caloric restriction in obese diabetic patients quickly improves glucose control, independently from weight loss. However, the early effects of a very-low-calorie diet (VLCD) on insulin sensitivity and insulin secretion in morbidly obese patients with type 2 diabetes are still unclear. Objective: The objective was to study the relative contributions of insulin sensitivity, insulin secretion, or both to improvement in glucose metabolism, after 1 wk of caloric restriction, in severely obese diabetic patients. Design: Hyperglycemic clamps were performed in 14 severely obese (BMI, in kg/m2: >40) patients with type 2 diabetes in good glucose control (glycated hemoglobin <7.5%) before and after 7 d of a VLCD (400 kcal/d). Results: The VLCD caused a 3.22 ± 0.56% weight loss (P <0.001), 42.0% of which was fat loss, accompanied by decreases in fasting plasma glucose (P <0.05) and triglycerides (P <0.01). In parallel, the Disposition Index, which measures the body's capability to dispose of a glucose load, increased from 59.0 6 6.3 to 75.5 ± 6.3 mL· min-1 · m-2 body surface area (P <0.01), because of improvements in indexes of both first- and second-phase insulin secretion (P <0.02), but with no changes in insulin sensitivity (P = 0.33). Conclusion: The marked improvement in metabolic profile, observed in severely obese patients with type 2 diabetes after a 7-d VLCD, was primarily due to the amelioration of β cell function, whereas no contribution of insulin sensitivity was shown. This trial was registered at www.clinicaltrials.gov as NCT01447524.

Original languageEnglish
Pages (from-to)609-613
Number of pages5
JournalAmerican Journal of Clinical Nutrition
Volume95
Issue number3
DOIs
Publication statusPublished - Mar 1 2012

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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