A Head-to-Head Comparison of the Postprandial Effects of 3 Meal Replacement Beverages Among People With Type 2 Diabetes

Purpose The purpose of this study was to compare the effects of 3 meal replacement beverages on glycemic response among people with type 2 diabetes. Methods The study examined Glucerna (R) Weight Loss Shake, Slim-Fast (R) Shake, and Ensure (R) with Fiber Shake, using a prospective, 3-way, cross-over design. Eighteen subjects with type 2 diabetes drank the beverages in random order on different weeks. The volume of each beverage was adjusted to include 50 grams of carbohydrates. Glucose was measured 0 to 180 minutes postprandial. Analyses included 2-factor analysis of variance (ANOVA) for repeated measures on both factors, calculation of area under the curve (AUC), and 1-way repeated measures ANOVA of AUC. Results The postprandial glucose profiles of the shakes differed. Glucerna (R) had the best profile as indicated by the graph of mean postprandial glucose levels and its lower incremental AUC. Despite the superiority of Glucerna (R), 2-hour postprandial blood glucose values exceeded the ADA's recommended upper limit for 22% of the subjects. Conclusions Meal replacement beverages are a popular and potentially effective option for people trying to lose or maintain weight; however, it is unknown to what degrees they affect postprandial blood glucose in people with type 2 diabetes. Because postprandial glycemic excursion is linked to cardiovascular disease, identifying a meal replacement beverage with the lowest glycemic response may mitigate some of the risks in patients with diabetes. Of the meal replacements observed in this study, Glucerna (R) had the smallest effect on postprandial glucose. Glycemic response to meal replacements should be monitored given product and individual variability.