Advancements in the Nutritional Management of Type 2 Diabetes

Good nutrition and lifestyle play a vital role in helping to reverse or manage type 2 diabetes

Good nutrition has long been recognized as a key tenet of diabetes management. Those who take the time to learn about and implement good nutrition and lifestyle modifications, including regular exercise and medication adjustments, can make huge progress in their diabetes control.

Similar to how other aspects of diabetes management have evolved and progressed with the introduction of new tools and technology, the knowledge and understanding of the role of nutrition in diabetes management has also advanced thanks to science.

Very Low-Calorie Diets and Type 2 Diabetes Remission

Recent research shows that remission of type 2 diabetes is possible for some individuals using certain interventions, like following very low-calorie diets.[ Riddle MC, et al. Diabetes Care. 2021 Aug 30;44(10):2438-2444.]

“We have seen encouraging results when individuals with type 2 diabetes participate in a multifaceted weight management program,” said Osama Hamdy, MD, PhD, Joslin Diabetes Center’s Medical Director, Obesity Clinical Program and Director of Inpatient Diabetes Program, during an Abbott symposium at the American Diabetes Association’s 83rd Scientific Session. “Following a very low-calorie diet and time-restricted fasting for 16 hours helps individuals with type 2 diabetes lose weight, which ultimately can induce diabetes remission.” Dr. Hamdy presented the Diabetes Remission Outcome Protocol (DROP), which used this nutrition intervention for 12 weeks—combined with strength training—followed by 9 months of a low-calorie diet and exercise. Individuals with diabetes for less than five years had remission from diabetes.[ Kibaa K, et al. Diabetes 2023;72(Supplement_1):733-P]

In one study, one year after individuals followed a very low-calorie diet as part of a weight management intervention, almost half were in remission of type 2 diabetes.[ Lean ME, et al. Lancet. 2018 Feb 10;391(10120):541-551.] At 2 years, nearly 1 in 3 remained in remission.[ Lean ME, et al. Lancet Diabetes Endocrinol. 2019 May;7(5):344-355.] Because of this emerging data, very low-calorie diets using meal replacements, including diabetes-specific nutrition formulas, are recommended by diabetes medical societies like Diabetes Canada.[ Jin S, et al. Can J Diabetes. 2022 Dec;46(8):762-774.]

Personalizing Nutrition Care for Individuals with Diabetes

While very low-calorie diets may work for some individuals, others with diabetes may benefit from personalized medical nutrition therapy to manage their condition.

JOSE RODOLFO V. DIMAANO, JR., MD
“Speaking with a healthcare professional can help individuals develop a nutrition plan that is customized to their needs and lifestyle; but nutrition recommendations can be hard to customize to specific cultures or lifestyles,” said Jose Rodolfo V. Dimaano, Jr. MD, MD, Area Medical Director for Pacific Asia at Abbott. “For this reason, Abbott and an international group of experts developed the transcultural Diabetes Nutrition Algorithm (or tDNA)—a global diabetes nutrition care model that translates nutrition recommendations based on cultural differences in diets and lifestyle to improve diabetes management and outcomes.[ Mechanick JI, et al. Curr Diab Rep. 2012 Apr;12(2):180-94.]”

Local experts have started to adapt tDNA in many regions and countries around the world. A clinical trial in Malaysia studied the effect of implementing tDNA in the country and found that a lifestyle intervention program using tDNA helped adults with type 2 diabetes improve their diabetes control and body weight.[ Chee WSS, et al. BMJ Open Diabetes Res Care. 2017 Sep 26;5(1):e000384]

Nutritional tools, like tDNA, and advancing research, like studies looking at the potential impact of weight management programs that incorporate lifestyle modifications like low-calorie/low-carbohydrates diets, can empower healthcare professionals and individuals with type 2 diabetes to successfully manage their condition.

JOSE RODOLFO V. DIMAANO, JR., MD
Area Medical Director,
Pacific Asia, Abbott

Dr. Dimaano is the Area Medical Director for Pacific Asia at Abbott. He leads the medical affairs team who provides technical and scientific support to the nutrition business and facilitates engagements with healthcare professionals and customers across Pacific-Asia.

He joined Abbott in 2011 as the Head of the Medical, Regulatory Affairs, and Quality Assurance Department of its pharmaceutical business in the Philippines before assuming his current role.

Dr. Dimaano has more than 20 years’ experience working in the field of public health, pharmaceutical medicine, and food and nutrition, spanning government, academic and industry settings.

Prior to Abbott, Dr. Dimaano held medical affairs roles at various multinational pharmaceutical companies since 2002. Before moving to the industry, he served the Philippine public health system through his participation in health education initiatives. He was part of the team that implemented the food fortification program under the Early Childhood Development Project of the Department of Health to address micronutrient deficiencies in Filipino children.

Dr. Dimaano was a contributing writer and editor for modules developed for the University of the Philippines College of Public Health (Health Emergency Management) and the Institute of Human Genetics (Newborn Screening Program) of the National Institutes of Health. He has written and contributed articles on health and nutrition in medical and trade publications.

He has also practiced as a primary care physician for a few years after obtaining his medical degree.
Dr. Dimaano completed his BS Basic Medical Sciences degree under the Integrated Arts & Medicine Program (an accelerated medical course) at the University of the Philippines College of Medicine and earned his Doctor of Medicine degree from the same university.


DR. OSAMA HAMDY
Medical Director, Obesity Clinical
Program, Director of Inpatient Diabetes
Program at Joslin Diabetes Center

Dr. Osama Hamdy is the Medical Director, Obesity Clinical Program, Director of Inpatient Diabetes Program at Joslin Diabetes Center. He is also the associate Professor of Medicine at Harvard Medical School Boston, MA. He has been the Co- Chairman of the International Tran-Cultural

Diabetes Nutrition Group Global Task Force for almost a decade. He has also been part of various research investigations & published Peer-Reviewed articles in Print and other Media.

Dr. Hamdy has been awarded with Michaela Modan Memorial Award – American Diabetes Association & Best Mentor Award nomination – Harvard Medical School. His interests include clinical innovations – Weight Achievement and Intensive Treatment (Why WAIT) Program, Innovative Medical Nutrition Therapy for Diabetes Management and Transcultural Diabetes Nutrition Algorithm, Inpatient Diabetes Quality-Improvement Program (DQIP) for national and international application.

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