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Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans

BACKGROUND: South Asians (SA) constitute a quarter of the global population and are disproportionally affected by both type 2 diabetes (T2D) and heart failure. There remains limited data of the acceptability and efficacy of low-energy meal replacement plans to induce remission of T2D in SA. OBJECTIV...

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Autores principales: Athithan, Lavanya, Gulsin, Gaurav S., Henson, Joseph, Althagafi, Loai, Redman, Emma, Argyridou, Stavroula, Parke, Kelly S., Yeo, Jian, Yates, Thomas, Khunti, Kamlesh, Davies, Melanie J., McCann, Gerry P., Brady, Emer M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559709/
https://www.ncbi.nlm.nih.gov/pubmed/37811525
http://dx.doi.org/10.1177/20420188231193231
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author Athithan, Lavanya
Gulsin, Gaurav S.
Henson, Joseph
Althagafi, Loai
Redman, Emma
Argyridou, Stavroula
Parke, Kelly S.
Yeo, Jian
Yates, Thomas
Khunti, Kamlesh
Davies, Melanie J.
McCann, Gerry P.
Brady, Emer M.
author_facet Athithan, Lavanya
Gulsin, Gaurav S.
Henson, Joseph
Althagafi, Loai
Redman, Emma
Argyridou, Stavroula
Parke, Kelly S.
Yeo, Jian
Yates, Thomas
Khunti, Kamlesh
Davies, Melanie J.
McCann, Gerry P.
Brady, Emer M.
author_sort Athithan, Lavanya
collection PubMed
description BACKGROUND: South Asians (SA) constitute a quarter of the global population and are disproportionally affected by both type 2 diabetes (T2D) and heart failure. There remains limited data of the acceptability and efficacy of low-energy meal replacement plans to induce remission of T2D in SA. OBJECTIVES: The objective of this exploratory secondary analysis of the DIASTOLIC study was to determine if there was a differential uptake, glycometabolic and cardiovascular response to a low-energy meal replacement plan (MRP) between SA and White European (WE) people with T2D. METHODS: Obese adults with T2D without symptomatic cardiovascular disease were allocated a low-energy (~810 kcal/day) MRP as part of the DIASTOLIC study (NCT02590822). Comprehensive multiparametric cardiovascular magnetic resonance imaging, echocardiography, cardiopulmonary exercise testing and metabolic profiling were undertaken at baseline and 12 weeks. A comparison of change at 12 weeks between groups with baseline adjustment was undertaken. RESULTS: Fifteen WE and 12 SAs were allocated the MRP. All WE participants completed the MRP versus 8/12 (66%) SAs. The degree of concentric left ventricular remodelling was similar between ethnicities. Despite similar weight loss and reduction in liver fat percentage, SA had a lower reduction in Homeostatic Model Assessment for Insulin Resistance [−5.7 (95% CI: −7.3, −4.2) versus −8.6 (−9.7, −7.6), p = 0.005] and visceral adiposity compared to WE [−0.43% (−0.61, −0.25) versus −0.80% (−0.91, −0.68), p = 0.002]. Exercise capacity increased in WE with no change observed in SA. There was a trend towards more reverse remodelling in WE compared to SAs. CONCLUSIONS: Compliance to the MRP was lower in SA versus WE. Overall, those completing the MRP saw improvements in weight, body composition and indices of glycaemic control irrespective of ethnicity. Whilst improvements in VAT and insulin resistance appear to be dampened in SA versus WE, given the small sample, larger studies are required to confirm or challenge this potential ethnic disparity. TRAIL REGISTRATION: NCT02590822.
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spelling pubmed-105597092023-10-08 Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans Athithan, Lavanya Gulsin, Gaurav S. Henson, Joseph Althagafi, Loai Redman, Emma Argyridou, Stavroula Parke, Kelly S. Yeo, Jian Yates, Thomas Khunti, Kamlesh Davies, Melanie J. McCann, Gerry P. Brady, Emer M. Ther Adv Endocrinol Metab Original Research BACKGROUND: South Asians (SA) constitute a quarter of the global population and are disproportionally affected by both type 2 diabetes (T2D) and heart failure. There remains limited data of the acceptability and efficacy of low-energy meal replacement plans to induce remission of T2D in SA. OBJECTIVES: The objective of this exploratory secondary analysis of the DIASTOLIC study was to determine if there was a differential uptake, glycometabolic and cardiovascular response to a low-energy meal replacement plan (MRP) between SA and White European (WE) people with T2D. METHODS: Obese adults with T2D without symptomatic cardiovascular disease were allocated a low-energy (~810 kcal/day) MRP as part of the DIASTOLIC study (NCT02590822). Comprehensive multiparametric cardiovascular magnetic resonance imaging, echocardiography, cardiopulmonary exercise testing and metabolic profiling were undertaken at baseline and 12 weeks. A comparison of change at 12 weeks between groups with baseline adjustment was undertaken. RESULTS: Fifteen WE and 12 SAs were allocated the MRP. All WE participants completed the MRP versus 8/12 (66%) SAs. The degree of concentric left ventricular remodelling was similar between ethnicities. Despite similar weight loss and reduction in liver fat percentage, SA had a lower reduction in Homeostatic Model Assessment for Insulin Resistance [−5.7 (95% CI: −7.3, −4.2) versus −8.6 (−9.7, −7.6), p = 0.005] and visceral adiposity compared to WE [−0.43% (−0.61, −0.25) versus −0.80% (−0.91, −0.68), p = 0.002]. Exercise capacity increased in WE with no change observed in SA. There was a trend towards more reverse remodelling in WE compared to SAs. CONCLUSIONS: Compliance to the MRP was lower in SA versus WE. Overall, those completing the MRP saw improvements in weight, body composition and indices of glycaemic control irrespective of ethnicity. Whilst improvements in VAT and insulin resistance appear to be dampened in SA versus WE, given the small sample, larger studies are required to confirm or challenge this potential ethnic disparity. TRAIL REGISTRATION: NCT02590822. SAGE Publications 2023-10-06 /pmc/articles/PMC10559709/ /pubmed/37811525 http://dx.doi.org/10.1177/20420188231193231 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Athithan, Lavanya
Gulsin, Gaurav S.
Henson, Joseph
Althagafi, Loai
Redman, Emma
Argyridou, Stavroula
Parke, Kelly S.
Yeo, Jian
Yates, Thomas
Khunti, Kamlesh
Davies, Melanie J.
McCann, Gerry P.
Brady, Emer M.
Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title_full Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title_fullStr Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title_full_unstemmed Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title_short Response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between South Asians and White Europeans
title_sort response to a low-energy meal replacement plan on glycometabolic profile and reverse cardiac remodelling in type 2 diabetes: a comparison between south asians and white europeans
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10559709/
https://www.ncbi.nlm.nih.gov/pubmed/37811525
http://dx.doi.org/10.1177/20420188231193231
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