Obesity Clinical Trial
Official title:
Evaluation of Efficacy and Safety of Ketogenic Complete Meal Replacement as Treatment of Obesity-related Type 2 Diabetes Mellitus
The purpose of the study is to evaluate the efficacy and safety of ketogenic diet (KD) complete meal replacement treatment of obesity-related Type 2 diabetes mellitus (T2DM) and of obesity in patients with obesity and T2DM. This will be an open-label single arm study evaluating glycemic control and weight loss in obese participants with type 2 diabetes treated for 6 months with 3:1 [fat]:[protein+carbohydrate] ratio, 1600 kcal/day diet.
The purpose of the study is to evaluate the efficacy and safety of ketogenic diet (KD)
complete meal replacement treatment of obesity-related Type 2 diabetes mellitus (T2DM) and of
obesity in patients with obesity and T2DM. This will be an open-label single arm study
evaluating glycemic control and weight loss in obese participants with type 2 diabetes
treated for 6 months with 3:1 [fat]:[protein+carbohydrate] ratio, 1600 kcal/day diet.
Treatment will consist of KD complete meal replacement with 3:1 [fat]: [protein +
carbohydrate] weight ratio, and with 1600 kcal restriction. It will consist of pre-made
meals, including breakfast, lunch, dinner and two snacks, one each between breakfast and
lunch and lunch and dinner. Meals will be made according to supplied recipes (Anemone, LLC.)
with a 3-week long meal plan consisting of different recipes for the 3 meals and 2 snacks
different for each day of the 3-week cycle, with repeating cycles. All KD-treated
participants will receive the same meal plan. Meals will be prepared uniformly by one
facility and will be delivered to participants frozen once a week in packages subdivided into
individual days with each day's package containing 5 separately packaged meals. Participants
will be given a list of allowed 0 calories drinks and will consume no non-allowed beverages.
Reductions to oral glycemic medications will occur at the start of the diet.
Participants will be evaluated in face-to-face visit during weeks 1, 2 and 4 of the study,
then monthly (see Table 1, visit schedule). Evaluations will include weight, BMI, BP, waist
circumference, adverse events and treatment compliance. Participants will check their blood
glucose levels 3x/day, including am fasting, mid-day and evening 2 hours post-prandial, and
urine for ketones levels with Ketostix (Bayer AG, IN, U.S.A.) 2x/day. They will record
results in a glucose and ketone level diary which will be reviewed at each visit. Laboratory
evaluations will include 8 am serum fasting glucose, insulin levels, C-peptide and lipid
panel, HbA1C, serum beta-hydroxybutyrate (BOH), leptin levels, C-reactive protein (CRP),
complete blood count (CBC), basic metabolic profile (BMP), renal and liver functions tests
(LFTs), and uric acid. Laboratory evaluations will be obtained once at baseline prior to
treatment initiation, at 3 and 6 months after treatment initiation. Hunger will be evaluated
with a 7-point Likert scale (range: extremely hungry to extremely full) which will be
administered at each visit.
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