What should the doctor prescribe-formula diet or antidiabetics? Effectiveness of formula diet-based lifestyle intervention vs. pharmacological antiglycemic therapy on weight loss and HbA1c reduction in type 2 diabetes patients-a systematic review
Abstract
Aim: Lifestyle intervention is the basis in type 2 diabetes therapy and leads, combined with formula diet, to substantial improvements in body weight and glycemic control up to diabetes remission. However, pharmacological therapies have also shown promising results. The aim of this systematic review was to compare the effects of large-sized formula diet-based lifestyle interventions vs. pharmacological interventions with glucagon-like peptide 1 receptor agonists (GLP-1 RAs), GLP-1, and glucose-dependent insulinotropic polypeptide (GIP) combinations and sodium glucose cotransporter-2 (SGLT-2) inhibitors on weight and HbA1c reduction in obese type 2 diabetes patients.
Methods: Literature searches were performed using PubMed for articles published until February 5, 2025. Primary and secondary outcomes were changes in weight [kg] and HbA1c [%] determined as estimated treatment difference (ETD) of intention-to-treat analyses (with a treatment policy approach).
Results: Of 1,409 identified articles, 54 articles describing 3 formula diet-based lifestyle interventions as well as 47 randomized, placebo-controlled pharmacological studies met our inclusion criteria including n=87.871 patients (32.8 ± 1.7 kg/m², 60 ± 4 years, 43 ± 7% women). Formula diet-based lifestyle intervention might more strongly reduce weight compared with pharmacological interventions with GIP/GLP-1 RAs or SGLT-2 inhibitors after <12 months (studies' mean values: -5.6 vs. -2.6 kg) or ≥12-month intervention…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 871 participants or records.
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