Energy balance
In patients with type 2 diabetes, a very low-calorie diet (VLCD) of 500 kcal/day achieves early improvements in insulin sensitivity and beta-cell function equivalent to Roux-en-Y gastric bypass (RYGB) when matched for the rate and magnitude of weight loss.
For patients with type 2 diabetes, achieving a very low-calorie intake (around 500 kcal/day) for about three weeks can restore insulin sensitivity and beta-cell function just as effectively as gastric bypass surgery, provided the weight loss is rapid and significant. This suggests that the early metabolic 'reset' is driven by the intensity of caloric restriction rather than surgical changes to the gut.
Based on these data, VLCD improves insulin sensitivity and b-cell function just as well as RYGB in the short term.
Why this rating
Randomized controlled trial design with matched cohorts, though limited by small sample size (n=25) and short duration (21 days).
Source
Very Low–Calorie Diet Mimics the Early Beneficial Effect of Roux-en-Y Gastric Bypass on Insulin Sensitivity and β-Cell Function in Type 2 Diabetic Patients
Clifton Jackness et al. · Diabetes · 2013
DOI 10.2337/db12-1762
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