1. Inducing remission of Type 2 diabetes in the Caribbean: findings from a mixed methods feasibility study of a low‐calorie liquid diet‐based intervention in Barbados.
- Author
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Bynoe, K., Unwin, N., Taylor, C., Murphy, M. M., Bartholomew, L., Greenidge, A., Abed, M., Jeyaseelan, S., Cobelli, C., Dalla Man, C., and Taylor, R.
- Subjects
BLOOD sugar ,CONFIDENCE intervals ,INGESTION ,INTERVIEWING ,RESEARCH methodology ,TYPE 2 diabetes ,REDUCING diets ,WEIGHT loss ,PILOT projects ,THEMATIC analysis ,TREATMENT effectiveness ,DISEASE remission ,DESCRIPTIVE statistics - Abstract
Aim: 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. Methods: Twenty‐five individuals with Type 2 diabetes diagnosed within past 6 years, not on insulin, BMI ≥ 27 kg/m2 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. Results: Ten men and 15 women (mean age 48, range 26–68 years) participated. Mean (sd) BMI was 34.2 kg/m2 (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. Conclusions: The feasibility of this approach to weight loss and diabetes remission in a predominantly black population in Barbados was demonstrated. What's new?: Studies of the remission of Type 2 diabetes through dietary means in people with a recent diagnosis have, to date, been conducted in predominantly white populations in the UK.In a predominantly black Caribbean population with Type 2 diabetes, diet‐induced mean weight loss of 10 kg was associated with remission (fasting plasma glucose < 7.0 mmol/l) in 60% of participants at 8 weeks, and 38% at 8 months.Negative peer pressure in social situations was one of several challenges participants reported.Remission of Type 2 diabetes is possible in this population.Further support to achieve and maintain greater weight loss is desirable. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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