Pharmacy Diabetes

DPR-session-3-The KnowDiabetes Diabetes Prevention Program

  • The KnowDiabetes Diabetes Prevention and Remission Program (KD DPRP) is a structured weight management program with 4 phases, lasting 13 – 21 weeks in total.
  • Participants need to lose an average of 7.5% of their body weight to reverse impaired glucose metabolism (impaired glucose tolerance or impaired fasting glycemia).
  • 7.5% of body weight is equivalent to 6 kg for an average 80 kg Australian adult.
  • People with higher levels of adiposity will need to lose more weight, and will consequently take longer to complete the program and reach this goal.
  • Phase 1: lasts 4 – 12 weeks and is the intense phase of the VLED program, with participants consuming 3 total meal replacements per day
  • Phase 2: kicks-off the stepped food re-introduction and lasts 3 weeks. Participants consume 2 total meal replacements per day, plus a reduced-energy dinner.
  • Phase 3: continues the stepped food re-introduction, with participants consuming 1 total meal replacement per day, plus an reduced-energy lunch and dinner, for 3 weeks.
  • Phase 4: participants consume a reduced-energy breakfast, lunch and dinner for the final 3 weeks.

Then, referral to Allied Health Professionals for specific diet and physical activity advice if required.

Refeeding (stepped food re-introduction)
  • Prolonged refeeding duration after successful VLED-induced weight loss beneficially affects weight management and eating behaviour.
  • Comparing a 1-week food reintroduction to 6 weeks, in 169 adults.
  • People in the 6-week group regained significantly less weight (3.9 %) as compared with group 1 (8.2 %; P = 0.006)(ITT, P = 0.05).
  • Completers in 6-week group also maintained a higher level of dietary restraint after refeeding was completed.
  • Overall, longer refeeding duration after successful weight loss with a VLED improves weight maintenance.