- Combining some type of calorie restriction with common medications used for weight loss and diabetes treatment may be a particularly effective way to manage type 2 diabetes.
- This combination therapy appears to improve the function of cells that produce insulin.
- Although these results are promising, they are preliminary and need to be replicated.
According to a recently published study, Clinical Nutrition The study concluded that the combination of semaglutide (Ozempic) and a very-low-calorie diet may be more effective in treating type 2 diabetes than either drug alone.
The researchers found that a very low-calorie diet resulted in greater short-term weight loss than semaglutide, and adding a very low-calorie diet to semaglutide treatment resulted in greater weight loss than semaglutide alone.
However, the combination did not result in greater weight loss than the very-low-calorie diet alone.
Importantly, the combination of a very low-calorie diet and semaglutide significantly improved the function of pancreatic beta cells, the cells in the pancreas that produce insulin.
Type 2 diabetes is a serious and growing concern in the United States and abroad. The rapid increase in prevalence has led to a surge in research in recent years.
It is clear that increased body fat levels increase the risk of developing diseases. Seven-fold increase are in danger.
The link between obesity and type 2 diabetes is, at least in part, because excess weight is associated with insulin resistance and impaired beta cell function.
It's a double-edged sword: insulin resistance means that your body's tissues don't respond properly to insulin, and beta cell dysfunction means that your pancreas produces less insulin.
In other words, obesity means that less insulin is available, and the insulin that is available doesn't work as effectively.
Excess weight plays a vital role in the risk of type 2 diabetes, so weight loss is an important part of diabetes management.
Semgaltide was originally developed as a treatment for type 2 diabetes. the work By increasing the amount of insulin produced after a meal, it helps keep blood sugar levels within a healthy range.
It also suppresses the production of glucagon, a hormone that increases blood sugar levels. Improve Beta cell function. Recently, semaglutide has gained popularity as a powerful weight loss drug.
Similarly, studies have shown that eating a very low-calorie diet (800 calories per day): Significant weight loss.
However, it is incredibly difficult to maintain a very low-calorie diet. Some studies have shown that one third 100% of participants on a very low calorie diet were unable to maintain the low energy intake and dropped out.
Although the evidence for both interventions is good, there have been no direct comparisons of the two approaches, nor have any studies investigated how effective the combination of a very low calorie diet with semaglutide is. This new study fills this void.
For the study, the scientists recruited 30 people with type 2 diabetes and randomly divided them into three groups.
- Semaglutide
- Very low calorie diet — 800 calories per day
- Semaglutide in combination with a very low-calorie diet.
The study lasted for 12 weeks. Before and after the study, the scientists assessed:
- body weight.
- Glycosylated hemoglobin (HbA1c)—an indicator of blood glucose levels.
- Dual-energy X-ray absorptiometry — A method of measuring body composition.
- Intravenous glucose tolerance test (IVGTT) — This evaluates the first phase of insulin release and is a marker of beta cell function.
“Insulin is secreted by the pancreas in a biphasic manner, meaning in two waves. The first phase is when insulin is initially released in response to sugar in the body.” Mir Ali, MDsaid Today's Medical News.
Ali is a board-certified bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif. He was not involved in the study.
The first phase is rapid and triggered by glucose in the blood, while the later second phase is longer, slower, and independent of blood sugar levels.
At the end of the study, the scientists found that the very-low-calorie diet, and the combination of the very-low-calorie diet with semaglutide, led to greater loss of body weight and fat mass than semaglutide alone.
HbA1c and fasting plasma glucose levels were significantly reduced in all three groups. Importantly, fasting insulin levels and insulin sensitivity improved only in the VLD and combination groups.
The scientists also found that there was an increased first-phase insulin response in patients taking semaglutide alone versus the combination group, and this increase was more pronounced with the combination treatment than with the very-low-calorie diet.
So, although the very low-calorie diet induced more weight loss than semaglutide, the combination of the two was most effective. This combination also significantly improved beta cell function, an important indicator of improved diabetes control.
Franklin Joseph, M.D.Dr. Frank's chief medical officer at the weight loss clinic, who was not involved in the study, MNT He was surprised at the results. [very low-calorie diet] Although there were significant reductions in body weight, fat mass, and insulin resistance, beta cell function did not appear to be enhanced.”
The authors suggest that this is because the participants had had type 2 diabetes for a long time. According to Joseph, this highlights the fact that “aggressive weight loss interventions to achieve remission need to occur early in the course of diabetes.”
This study suggests that a very low-calorie diet combined with semaglutide may be an effective way to manage type 2 diabetes, although this is only a pilot study with a small number of participants and more research is needed.
Also, 12 weeks is a relatively short period to evaluate weight loss and type 2 diabetes management. It is important to understand what happens in the long term.
talk MNT,Megan Warnke, RDNa registered dietitian and certified diabetes care and education specialist who was also not involved in the study, explained that very low-calorie diets are not a viable approach except as a short-term intervention.
“The key phrase in this study is 'short-term results.' As with any diet, this approach may work in the short term, but the long-term results are not sustainable.”
“The appetite suppression provided by semaglutide can help patients stick to a calorie-restricted diet, but other factors such as stress, sleep and food insecurity also affect the 'success' of dieting – something the drug cannot solve,” Warnke explained.
Joseph agreed, saying: MNTthat “[t]The appetite suppressant effect of semaglutide [very low-calorie diet].”
But many questions remain. “Will the hunger rebound cause a voracious appetite and rapid weight gain?” Joseph speculates. [very low-calorie diet] Will continued long-term semaglutide help maintain the weight loss and blood sugar control achieved?
Overall, Joseph believes this approach may be useful in the future: “We are increasingly focused on getting patients into remission of their diabetes as quickly as possible, and the improvement in beta cell function suggests that this approach may be even more beneficial in achieving remission,” he noted.