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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

Lookup NU author(s): Professor Roy Taylor

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell, 2019.

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Abstract

© 2019 Diabetes UK. 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.


Publication metadata

Author(s): Bynoe K, Unwin N, Taylor C, Murphy MM, Bartholomew L, Greenidge A, Abed M, Jeyaseelan S, Cobelli C, Dalla Man C, Taylor R

Publication type: Article

Publication status: Published

Journal: Diabetic Medicine

Year: 2019

Pages: Epub ahead of print

Online publication date: 31/07/2019

Acceptance date: 29/07/2019

Date deposited: 14/02/2020

ISSN (print): 0742-3071

ISSN (electronic): 1464-5491

Publisher: Wiley-Blackwell

URL: https://doi.org/10.1111/dme.14096

DOI: 10.1111/dme.14096

PubMed id: 31365159


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