J Korean Diabetes.  2022 Sep;23(3):206-212. 10.4093/jkd.2022.23.3.206.

Clinical Nutrition Therapy for Weight Control in Obese Diabetic Patients

• Kim M

• KMID: 2534307
• DOI: http://doi.org/10.4093/jkd.2022.23.3.206

Abstract

Clinical Practice Guidelines for Diabetes recommend that overweight or obese adults lose more than 5% of their body weight and reduce their total caloric intake to maintain the reduced body weight. In diabetic patients, the goal of weight control is not simply to lose weight, but to achieve health benefits by controlling blood sugar well and reducing the risk of complications and other comorbidities. An extremely calorie-restricted diet, whose long-term effectiveness has not been verified, is not recommended as it may increase the risk of hypoglycemia and ketoacidosis. For weight control in obese diabetic patients, it is important to follow diabetic diet guidelines while setting actionable energy goals that prevent hypoglycemia and do not increase health risks. The energy target should be adjusted in consideration of individual conditions such as daily intake, body size, and activity level.

Keyword

Diabetes mellitus; Diet therapy; Obesity management; Weight loss

Reference

1.Korean Society for the Study of Obesity. 2021 obesity fact sheet. Seoul: Korean Society for the Study of Obesity;2021.

2.Franz MJ., Boucher JL., Rutten-Ramos S., VanWormer JJ. Lifestyle weight-loss intervention outcomes in overweight and obese adults with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. J Acad Nutr Diet. 2015. 115:1447–63.

3.Look AHEAD Research Group., Wing RR., Bolin P., Bran-cati FL., Bray GA., Clark JM, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013. 369:145–54. Erratum in: N Engl J Med 2014; 370:1866.

4.Lean MEJ., Leslie WS., Barnes AC., Brosnahan N., Thom G., McCombie L, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, clus-ter-randomised trial. Lancet Diabetes Endocrinol. 2019. 7:344–55.

5.Korean Diabetes Association. Clinical practice guidelines for diabetes. 7th ed.Seoul: Korean Diabetes Association;2021.

6.The Korean Society of Hypertension. 2018 Guidelines of hypertension treatment. Seoul: The Korean Society of Hypertension;2018.

7.Evert AB., Dennison M., Gardner CD., Garvey WT., Lau KHK., MacLeod J, et al. Nutrition therapy for adults with diabetes or prediabetes: a consensus report. Diabetes Care. 2019. 42:731–54.

8.Korean Society for the Study of Obesity. 2020 Korean Society for the Study of Obesity guidelines for the management of obesity in Korea. Seoul: Korean Society for the Study of Obesity;2020.

9.Sacks FM., Bray GA., Carey VJ., Smith SR., Ryan DH., An-ton SD, et al. Comparison of weight-loss diets with dif-ferent compositions of fat, protein, and carbohydrates. N Engl J Med. 2009. 360:859–73.

10.Gardner CD., Trepanowski JF., Del Gobbo LC., Hauser ME., Rigdon J., Ioannidis JPA, et al. Effect of low-fat vs low-car-bohydrate diet on 12-month weight loss in overweight adults and the association with genotype pattern or in-sulin secretion: the DIETFITS randomized clinical trial. JAMA. 2018. 319:667–79. Erratum in: JAMA 2018;319: 1386. Erratum in: JAMA 2018;319):1728.

11.Kim J. Effects of a low-carbohydrate, high-fat diet. Korean J Obes. 2016. 25:176–83.

12.Ministry of Health and Welfare; The Korean Nutrition Society. 2020 Dietary reference intakes for Koreans. Se-jong: Ministry of Health and Welfare;2020.

13.Kong A., Beresford SAA., Alfano CM., Foster-Schubert KE., Neuhouser ML., Johnson DB, et al. Self-monitoring and eating-related behaviors are associated with 12-month weight loss in postmenopausal overweight-to-obese wom-en. J Acad Nutr Diet. 2012. 112:1428–35.

14.Blau JE., Tella SH., Taylor SI., Rother KI. Ketoacidosis associated with SGLT2 inhibitor treatment: analysis of FAERS data. Diabetes Metab Res Rev. 2017. 33:e2924.

15.Sellahewa L., Khan C., Lakkunarajah S., Idris I. A systematic review of evidence on the use of very low calorie diets in people with diabetes. Curr Diabetes Rev. 2017. 13:35–46.