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Is There a Role for Diabetes-Specific Nutrition Formulas as Meal Replacements in Type 2 Diabetes?
Jarvis C Noronha1,2, Jeffrey I Mechanick3
1Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada.
Abstract:
Nutrition therapy plays an integral role in the prevention and management of patients with type 2 diabetes (T2D). A potential strategy is the utilization of diabetes-specific nutrition formulas (DSNFs) as meal replacements. In this article, we distinguish DSNFs from standard nutrition formulas, review the clinical data examining the effectiveness of DSNFs, and propose an evidence-based algorithm for incorporating DSNFs as part of nutrition therapy in T2D. DSNFs contain slowly-digestible carbohydrates, healthy fats (e.g., monounsaturated fatty acids), and specific micronutrients, which provide added benefits over standard nutrition formulas. In short- and long-term clinical trials, DSNFs demonstrate improvements in postprandial glycemic responses translating into sustainable benefits in long-term glycemic control (e.g., hemoglobin A1c and glycemic variability) and various cardiometabolic outcomes. To facilitate the delivery of DSNFs in a clinical setting, the transcultural diabetes nutrition algorithm can be utilized based on body weight (underweight, normal weight, or overweight) and level of glycemic control (controlled or uncontrolled).
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