NIDDM and VLCD diet
NIDDM is non-insulin dependent diabetes mellitus, or diabetes mellitus independent of insulin treatment. This is II. a type of diabetes that arises from a decrease in the sensitivity of cells to insulin and is considered a disease of civilization. Conventional methods of treating obese patients with NIDDM are often unsatisfactory. Patients do not always willingly follow regimens and dietary recommendations and often end up on insulin treatment due to PAD (oral diabetes). VLCD diets are diets with a very low energy intake below 800 kcal/day and their composition tends to be different. Diets where the majority of energy intake is represented by protein are highly successful, as protein has a high satiating effect and at the same time protects muscle mass during reduction. We wrote more about VLCD diets for you in the article: "The most effective way to reduce - VLCD diet!".
VLCD diet as an alternative treatment for patients with NIDDM
The results of the study of the effects of the VLCD diet on patients with NIDDM were presented in the scientific journal "Diabetes Research and Clinical Practice" and were truly revolutionary. Here, the effect of the VLCD diet on the reduction of blood sugar, but also the reduction of the waist circumference and the related risk of cardiovascular diseases, was monitored.
The study was conducted on 14 obese patients (7 men and 7 women) with an average age of 51 years, an average BMI of 38.7 kg-2, an average waist circumference of 116 cm, and poorly compensated diabetes. The value of glycated hemoglobin (HbA1c), is a longer-term indicator of DM II treatment. type than current blood glucose values, according to the IFCC (International Federation of Clinical Chemistry and Laboratory Medicine) exceeded 8.6% on average, the norm is 2.8-4.0%. Seven patients with NIDDM were treated only with PAD (oral antidiabetic drugs), six of them were on combined PAD + insulin therapy, and one patient was on insulin therapy only. It should be noted that patients with extensive liver and kidney damage, cardiovascular disease, psychiatric diagnoses, and eating disorders were excluded from the study.
Selected 14 patients were given a VLCD diet (425 kcal/day) for 12 weeks. Patients were given a VLCD diet in the form of certified instant meals with a high protein content. The patients received three meals a day, which were mixed in 250 ml of water, and their total energy sum per day was 425 kcal. With these meals, patients could consume only two bowls of vegetables and 2 liters of non-caloric beverages. After 4 weeks, the diet was gradually eased to reintroduce the weight maintenance diet slowly. All the time, the patients were monitored by several experts and had to measure their postprandial glycemia (blood sugar value after a meal) regularly. A total of 13 patients completed the study.
The result of the study was a rapid reduction of postprandial glycemia, by a total of 25% after only two days of treatment. There were also significant weight losses here, from a median of 108.9 kg to 94.5 kg. The patients also made great progress in terms of cm loss in the waist. From the median of 116.0 to 103.0 cm. HbA1c (glycated hemoglobin) decreased by a total of 1.5% on the IFCC rating scale. There was also a decrease in blood pressure (from a median of 138/78 mmHg to a median of 130/74 mmHg), total cholesterol (median before treatment 5.7 mmol/l and after treatment 4.8 mmol/l), an increase in HDL cholesterol and a decrease in triacylglycerols. As for diabetic treatment, during the 12 weeks on the VLCD diet, no patient remained on insulin treatment, and most patients even managed to reduce their PAD doses. And that from a median of 8 tablets per day (in the range of 6-12 tablets/day) to a median of 2 tablets per day (in the range of 0-8 tablets/day).
Conclusion
Pharmacological treatment of NIDDM patients is often a therapeutic dilemma as it leads to weight gain. Treatment of NIDDM patients with VLCD diets is very effective, not only for lowering the glycemic profile but also for weight loss and reducing the risks associated with metabolic syndrome. Several other studies have been conducted in the following years, and the effect of the VLCD diet on the treatment of NIDDM patients and obesity is still under investigation with positive results.
Sources: Capstick, F., Brooks, B.A., Burns, C.M., Zilkens, R.R., Steinbeck, K.S., & Yue, D.K. (1997). Deficient calorie diet (VLCD): a useful alternative in the treatment of obese NIDDM patients. Diabetes research and clinical practice, 36(2), 105–111. https://doi.org/10.1016/s0168-8227(97)00038-7
