Study shows meal replacement shakes improve t2d glucose management

A pilot study showed that a diabetes-specific nutritional shake (DSNS) used twice-daily as a meal replacement for breakfast and an afternoon snack or pre-bedtime snack by people with Type 2 diabetes using continuous glucose monitoring (CGM) and oral medications improved glucose and dietary management.

The study was conducted in two phases over 14 consecutive days at 8 clinical centers across North America with 81 adults with Type 2 diabetes who manage it with oral medications.

In the first phase, days 1-6, participants ate their usual diets, followed by the second phase, days 7-14, when they were randomly selected to one of the following groups: to receive no meal replacement shake; receive a meal replacement for breakfast and an afternoon snack; and a meal replacement for breakfast and a pre-bed snack. Glucose was monitored using continuous glucose monitoring.

Study participants were on these oral medications to manage Type 2 diabetes: 90% metformin, 53% sulfonylureas, and 4% thiazolidinediones (TZDs). The duration of their life with diabetes ranged from 1 year to 37 years.

Before this study, research to study the impact of DSNS on glucose management in patients with Type 2 diabetes were conducted in restricted, controlled environments. This new study is the first to provide evidence that DSNS has a positive impact on glucose in individuals with T2D in a “real-world” setting.

Here are some of the other new findings presented by the study:

  • The results showed reduced glucose variability at nighttime.
  • Participants who replaced one meal and one afternoon snack per day with a meal replacement shake significantly reduced cravings for starchy foods, salty snacks, chocolate, and candy.
  • The structure of having two replacement drinks at a specific time of the day had an impact on glucose variability between the highest and lowest glucose peaks within a 24-hour period, especially at night.
  • The addition of a second meal replacement increased the overall feeling of having control over food choices.

How Meal Replacement Shakes are Typically Used to Treat Type 2 Diabetes

Meal replacement shakes are used to treat people with Type 2 diabetes for some of the following reasons:

  • They’re convenient to consume, meaning no extra meal prep is required.
  • They provide known calorie amounts with specific information about macro- and micronutrient levels that considered in meal planning.
  • Diabetes-specific nutrition shakes, in particular, contain the type and amount of carbohydrate, as well as other macronutrients, to provide quality nutrition while minimizing the impact on post-meal glucose levels.
  • Since blood sugar is frequently higher in the morning than other times of the day, meal replacement shakes can be used for breakfast, instead of breakfast options higher in carbohydrate and saturated fats.
  • Meal replacement shakes used as a substitute for one or two meals as part of an intensive lifestyle intervention significantly reduced A1C and the need for diabetes medications.

Another note is how they noted the current guidelines that emphasize the importance of nutrition in diabetes management are complex due to the cultural, personal, and behavioral factors that can affect one’s ability to stick to a diet plan. Meal replacements can be used to overcome those barriers.

What’s Next?

Though the researchers of the study concluded that diabetes-specific meal replacement drinks are beneficial for Type 2 diabetes management, they acknowledged further research should consider a larger group of participants who can use a real-time CGM, which would allow them to evaluate their individual responses to the DSNS and track dietary and behavioral changes to achieve their glycemic goals. Another consideration for future research is collecting cultural responses to meal replacements in different settings.

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They are horrible to drink though. They are like super sweet vanilla snot. I had to drink them after a surgery because I needed to get extra calories and I had no appetite.
Since then I can’t stand to look at them.
Why do they have to put so much artificial sweetener in them?
I don’t eat any sweetness. I game them up years ago. When I eat something with large amounts, it is repulsive.
I just eat sugar in smaller amounts when I want something sweet and I simply correct for it.

The artificial sweetener idea has been proven to mess with your metabolism and make you more likely to gain weight. If weight is an issue. Generally is more for type 2 than type 1.
Once I got off that train my glucose control got better and I feel better and my weight is stable.
6’3. 185 Not super thin but not overweight either.
I was over 200 when I read an article about meal replacements and artificial sweeteners.
It is easier to give up than you might think.
As diabetics we get a lot of push toward zero calorie or managed calorie items, but really I think it’s best to eat reasonable portions and cover them with whatever meds you are on.

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Nutritional shakes are just bad substitutions for correct portions and carb counts or real food. And You can’t really chew anything, Just not a great idea,