Scientists at the University of Nottingham, UK, have conducted a short-term intervention study demonstrating the effectiveness of a very low-calorie diet (VLCD) combined with Semaglutide in reducing body weight and controlling blood glucose in patients with type 2 diabetes. The findings are published in the journal Clinical Nutrition.
Study Overview
The study explored the metabolic effects of VLCD and Semaglutide, both individually and in combination, on body weight, body composition, and metabolic outcomes in type 2 diabetes patients. Type 2 diabetes is marked by high blood glucose levels and insulin resistance, primarily due to impaired insulin secretion from pancreatic beta-cells. Overweight and obesity are significant risk factors, with obesity increasing diabetes risk sevenfold and contributing to insulin resistance and beta-cell dysfunction.
Semaglutide, a GLP-1 receptor agonist, is effective in reducing body weight. Similarly, VLCD is a potent weight loss strategy known for restoring beta-cell function and improving glycemic control. This study aimed to assess their combined efficacy.
Study Design
Thirty adult individuals with type 2 diabetes and a BMI between 27 and 50 kg/m² were randomly assigned to three groups: VLCD, Semaglutide, and a combined VLCD-Semaglutide group. The VLCD group followed an 800-kilocalorie per day diet, while the Semaglutide group received weekly subcutaneous injections, starting at 0.25 mg and increasing to 1 mg biweekly. The combined group underwent both interventions for 12 weeks.
Participants’ body weight, body composition, glycated hemoglobin levels, and beta-cell function were measured at baseline and post-intervention. Dietary compliance was assessed through diet diaries.
Key Findings
All intervention groups experienced significant weight reduction. However, the VLCD and combined groups saw a higher percentage body weight and BMI reduction compared to the Semaglutide group alone. Weight loss in the VLCD and combined groups was 5.4% and 7% higher, respectively, than in the Semaglutide group. Fat mass reduction was over twice as high in the VLCD and combined groups compared to the Semaglutide group, with no significant differences in lean body mass reduction across the groups.
Dietary assessments indicated better compliance and higher protein intake in the VLCD and combined groups, while fat intake was lower compared to the Semaglutide group.
Glycemic Control and Metabolic Outcomes
All groups showed significant reductions in glycated hemoglobin, with the combined group displaying the most substantial decrease. Fasting insulin levels significantly dropped in the VLCD and combined groups but slightly increased in the Semaglutide group. Fasting glucose reduction was similar across all groups. The acute insulin response to glucose increased significantly in the Semaglutide and combined groups, with a ninefold increase in the combined group compared to the VLCD group. The VLCD and combined groups also showed significant improvements in insulin sensitivity, unlike the Semaglutide group.
Adverse Events
The most common adverse effects in the Semaglutide group included mild nausea, constipation, abdominal discomfort, bloating, and lethargy. In the VLCD and combined groups, constipation was the most frequent issue, with some experiencing mild abdominal discomfort, nausea, or headaches.
Study Implications
This study demonstrates that combining Semaglutide with VLCD is more effective than using Semaglutide alone in enhancing pancreatic beta-cell function and reducing insulin resistance. VLCD alone is more efficient in reducing body weight and fat mass in a short period. Further long-term studies are necessary to fully understand the impact of the Semaglutide-VLCD combination on managing type 2 diabetes and obesity.
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