Study Shows Meal Replacement Shakes Improve T2D Glucose Management


A pilot study showed that a diabetes-specific nutritional shake (DSNS) (Glucerna Hunger Smart, Abbott) used twice-daily as a meal replacement for breakfast and an afternoon snack or pre-bedtime snack by people with type 2 diabetes (T2D) using continuous glucose monitoring (CGM) and oral medications improved blood glucose and dietary management.

The study was conducted in two phases over 14 consecutive days at eight clinical centers across North America with 81 adults with type 2 diabetes who manage it with oral medications.

In the first phase, days one to six, participants ate their usual diets, followed by the second phase, days seven to fourteen, when they were randomly selected to one of the following groups: to receive no meal replacement shake; receive a meal replacement for breakfast and an afternoon snack; and a meal replacement for breakfast and a pre-bed snack. Blood glucose was monitored using continuous glucose monitoring.

Study participants were on these oral medications to manage type 2 diabetes: 90 percent metformin, 53 percent  sulfonylureas and 4 percent thiazolidinediones (TZDs). The duration of their life with diabetes ranged from 1 year to 37 years.

Before this study, research to study the impact of DSNS on blood glucose management in patients with type 2 diabetes were conducted in restricted, controlled environments. This new study is the first to provide evidence that DSNS has a positive impact on blood glucose in individuals with T2D in a “real-world” setting.

Here are some of the other new findings presented by the study:

  • The results showed reduced blood glucose variability at nighttime.
  • Participants who replaced one meal and one afternoon snack per day with a meal replacement shake significantly reduced cravings for starchy foods, salty snacks, chocolate and candy.
  • The structure of having two replacement drinks at a specific time of the day had an impact on blood glucose variability between the highest and lowest blood glucose peaks within a 24-hour period, especially at night.
  • The addition of a second meal replacement increased the overall feeling of having control over food choices.

How Meal Replacement Shakes are Typically Used to Treat Type 2 Diabetes

Meal replacement shakes are used to treat people with type 2 diabetes for some of the following reasons:

  • They’re convenient to consume, meaning no extra meal prep is required.
  • They provide known calorie amounts with specific information about macro- and micronutrient levels that considered in meal planning.
  • Diabetes-specific nutrition shakes, in particular, contain the type and amount of carbohydrate, as well as other macronutrients, to provide quality nutrition while minimizing the impact on post-meal blood glucose levels.
  • Since blood sugar is frequently higher in the morning than other times of the day, meal replacement shakes can be used for breakfast, instead of breakfast options higher in carbohydrate and saturated fats.
  • Meal replacement shakes used as a substitute for one or two meals as part of an intensive lifestyle intervention significantly reduced A1C and the need for diabetes medications.

Another note is how they noted the current guidelines that emphasize the importance of nutrition in diabetes management are complex due to the cultural, personal and behavioral factors that can affect one’s ability to stick to a diet plan. Meal replacements can be used to overcome those barriers.

What’s Next?

Though the researchers of the study concluded that diabetes-specific meal replacement drinks are beneficial for type 2 diabetes management, they acknowledged further research should consider a larger group of participants who can use a real-time CGM, which would allow them to evaluate their individual responses to the DSNS and track dietary and behavioral changes to achieve their glycemic goals. Another consideration for future research is collecting cultural responses to meal replacements in different settings.

WRITTEN BY Beyond Type 2 Editorial Team, POSTED 08/06/20, UPDATED 10/04/22

This piece was authored collaboratively by the Beyond Type 2 Editorial Team.