Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus
- PMID: 8077323
- DOI: 10.1210/jcem.77.5.8077323
Relative effects of calorie restriction and weight loss in noninsulin-dependent diabetes mellitus
Abstract
In obese patients with noninsulin-dependent diabetes mellitus (NIDDM), reducing calorie intake improves glycemic control, often more rapidly than weight loss. Conversely, after weight loss has been achieved, metabolic control can deteriorate once calorie intake is increased, even if there is no regaining of weight. The current study, therefore, tested the hypothesis that restricting calorie consumption has an important role, independent of weight loss, in metabolic regulation of NIDDM patients. Isotopic determinations of hepatic glucose production (HGP), post-absorptively and after ingestion of 75 g glucose (dual glucose isotope method), were made in conjunction with measurement of insulin secretion and insulin sensitivity in seven obese NIDDM volunteers after four periods of controlled calorie intake: 1) 7 days of a baseline weight maintenance diet, 2) followed immediately by 7 days of calorie restriction (800 Cal/day); 3) followed by a weight loss program that consisted of 2 months of a very low calorie diet (400 Cal/day) and then 4 weeks of gradual refeeding and 7 days on a weight maintenance diet; and 4) a final week of calorie restriction (800 Cal/day). The initial brief interval of calorie restriction produced substantial decreases in fasting plasma glucose, HGP, and fasting plasma triglyceride and increases in insulin sensitivity and secretion. After a substantial weight loss (12.7 +/- 2 kg), each parameter improved further, with the effect of weight loss approximately equal to that obtained with initial calorie restriction. Reimposing calorie restriction after weight loss had little effect, except that fasting plasma glucose and HGP improved slightly further. In obese NIDDM subjects, a 7-day period of calorie restriction produces approximately half of the overall improvement in HGP, insulin sensitivity, and insulin secretion that is obtained after a substantial loss of weight. These findings indicate that calorie restriction has an important regulatory effect on the metabolism of obese patients with NIDDM that is independent of weight loss.
Similar articles
-
Effects of a behavioral weight loss program stressing calorie restriction versus calorie plus fat restriction in obese individuals with NIDDM or a family history of diabetes.Diabetes Care. 1995 Sep;18(9):1241-8. doi: 10.2337/diacare.18.9.1241. Diabetes Care. 1995. PMID: 8612437 Clinical Trial.
-
The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM.Diabetes Care. 1998 May;21(5):687-94. doi: 10.2337/diacare.21.5.687. Diabetes Care. 1998. PMID: 9589225 Clinical Trial.
-
Glycemic effects of intensive caloric restriction and isocaloric refeeding in noninsulin-dependent diabetes mellitus.J Clin Endocrinol Metab. 1985 Nov;61(5):917-25. doi: 10.1210/jcem-61-5-917. J Clin Endocrinol Metab. 1985. PMID: 4044780
-
Use of very-low-calorie diets in the treatment of obese persons with non-insulin-dependent diabetes mellitus.J Am Diet Assoc. 1995 May;95(5):569-72; quiz 573-4. doi: 10.1016/S0002-8223(95)00155-7. J Am Diet Assoc. 1995. PMID: 7722192 Review.
-
Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass.Dan Med J. 2015 Apr;62(4):B5057. Dan Med J. 2015. PMID: 25872541 Review.
Cited by
-
Increased Insulin Secretion and Glucose Effectiveness in Obese Patients with Type 2 Diabetes following Bariatric Surgery.J Diabetes Res. 2023 Nov 14;2023:7127426. doi: 10.1155/2023/7127426. eCollection 2023. J Diabetes Res. 2023. PMID: 38020201 Free PMC article.
-
Tighten Your Belt! Banded Roux-en-Y Gastric Bypass for Diabetes Remission?Diabetes Care. 2022 Jul 7;45(7):1495-1497. doi: 10.2337/dci22-0015. Diabetes Care. 2022. PMID: 35796772 Free PMC article. No abstract available.
-
Could Dietary Modification Independent of Energy Balance Influence the Underlying Pathophysiology of Type 2 Diabetes? Implications for Type 2 Diabetes Remission.Diabetes Ther. 2022 Apr;13(4):603-617. doi: 10.1007/s13300-022-01220-4. Epub 2022 Mar 10. Diabetes Ther. 2022. PMID: 35266093 Free PMC article. Review.
-
Type 2 diabetes and remission: practical management guided by pathophysiology.J Intern Med. 2021 Jun;289(6):754-770. doi: 10.1111/joim.13214. Epub 2020 Dec 27. J Intern Med. 2021. PMID: 33289165 Free PMC article. Review.
-
High-Intensity Interval Training Restores Glycolipid Metabolism and Mitochondrial Function in Skeletal Muscle of Mice With Type 2 Diabetes.Front Endocrinol (Lausanne). 2020 Aug 14;11:561. doi: 10.3389/fendo.2020.00561. eCollection 2020. Front Endocrinol (Lausanne). 2020. PMID: 32922365 Free PMC article.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical