Treatment of type 2 (non-insulin-dependent) diabetic patients with diet alone

Summary The effects of 3 months' diet therapy on glucose tolerance, plasma insulin response to oral glucose, fasting lipid levels and body weight were measured in 182 Type 2 (non-insulin-dependent) diabetic outpatients with fasting hyperglycaemia before treatment. Overall, there was a 25% improvement in glucose tolerance, a 58% increase in plasma insulin response during the glucose tolerance test, a 13.6% fall in fasting plasma triglyceride levels with no change in fasting cholesterol levels and a 5.1% fall in body weight. Of the 182 patients, 20% achieved normal glucose tolerance on diet alone for 3 months. These were mainly men of average age 63 years, who were 20% above their ideal body weight, and had milder glucose intolerance and higher residual insulin response to glucose before treatment than the 16% of patients who remained poorly controlled. These latter patients were mainly older women, 9% above their ideal body weight and with more marked glucose intolerance and less insulin response to glucose. These results demonstrate the practical limitations of this type of anti-diabetic therapy, particularly if normal glucose tolerance is a desired therapeutic aim.