Just Say No to Insulin and Meformin?

If you have a child with type 2 diabetes, South Carolina researchers suggest the possibility of getting him or her off of insulin and metformin and onto a very low calorie diet (VLCD) with medical supervision.

A chart review was conducted of 20 children, average age 14.5 years, who had consumed a strict ketogenic VLCD under medical supervision for the treatment of type 2 diabetes. The calorie levels were designed to be low enough to cause weight loss.

Before starting the diet, 11 of the 20 patients were treated with insulin and six with metformin. After the first three days of starting the very low calorie diet, average daily BG values fell from 160 to 99 mg/dl, and insulin and metformin could be discontinued in all but one subject.

The body mass index (BMI) and A1C levels dropped significantly as the diet was continued for 60 days. Sustained decreases in BMI and insulin requirements were observed in patients remaining on VLCD for at least six weeks, as compared with the control group.

None of the patients required resumption of insulin or metformin during the study period. The researchers conclude that this diet, though strict, is a potential alternative to pharmacologic therapies in the treatment of type 2 diabetes in youth.

Diabetes Care, February 2004

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