Meal Replacement Impacts on Individuals with Diabetes

Modest and sustained weight loss has been shown to reduce the need for glucose-lowering medications and improve glycemic control in overweight/obese individuals with type 2 diabetes. However, many of these individuals face challenges in achieving weight loss, in part, due to metabolic, psychological, and behavioral factors. The use of liquid meal replacements within a structured dietary plan may offer a viable solution. Liquid meal replacements provide a mixture of carbohydrates, fat, and protein, along with added vitamins and minerals, in ready-to-drink form or powder formulas that require mixing. They are frequently used to replace one or two main meals each day, or in some cases, all meals (i.e., total diet replacement). Current gaps in this area of research include identifying the type of formulations and complimentary aspects of a dietary program that yield long-term weight loss maintenance, reduce cardiometabolic risk, and increase the odds of diabetes remission in overweight/obese patients with type 2 diabetes.

This Research Topic will bring together some of the most distinguished clinician scientists in the field of Clinical Nutrition and Diabetes, through a collection of invited perspectives. The aim is to highlight key advancements and pioneering research in the field that were presented at the 38th International Symposium on Diabetes and Nutrition.
Through an expert lens, these perspective articles will cover the following themes in this area of research:
• Is there a role for diabetes specific meal replacements in nutrition therapy for type 2 diabetes?
• Meal replacements for weight related complications in type 2 diabetes: What is the state of the evidence?
• Total diet replacement in the context of an intensive lifestyle intervention for remission of type 2 diabetes: Lessons learned from DiRECT.
• Meal Replacement for Weight Loss, Diabetes Prevention and Remission. An Overview of the Evidence.

Topic Editor Conflict of Interest Declarations:
- Dr. Cyril WC Kendall has no financial disclosures specifically related to meal replacements that are relevant to this activity. For a full list of disclosures, please see: https://www.bmj.com/content/374/bmj.n1651
- Dr. John L Sievenpiper's financial disclosures with an interest in meal replacements that are relevant to this activity include Soylent (in-kind food donations for a randomized trial), Abbott (honoraria) and Nestle (honoraria). For a full list of disclosures, please see: https://www.bmj.com/content/374/bmj.n1651
- Simin Liu has received consulting fees from Stanford University, Fred Hutchinson Cancer Research Center, honoraria from General Mills Co, and is a consultant to Barilla, Palma, Italy. He has no financial disclosures specifically related to meal replacements that are relevant to this activity.