Effects of a very low calorie diet in type 2 diabetes.

Rationale:

Type 2 diabetes mellitus (DM2) is caused by profound disturbances in glucose and lipid metabolism, ultimately resulting in progressive atherosclerosis and microangiopathy.

In previous studies we have documented the metabolic and functional effects of dietary interventions on the heart in healthy subjects and patients with DM2 without overt cardiac complications. We hypothesize that dietary interventions also decrease myocardial TG stores and improve cardiac function in patients with DM2 and cardiovascular complications. This will open perspectives for dietary interventions which decrease myocardial TG stores and improve myocardial dysfunction in this category of patients.

We hypothesize that a very low calorie diet decreases myocardial TG stores and improves myocardial dysfunction in patients with DM2 and cardiovascular complications.

Very low calorie diet for 16 weeks. Patients have a MRI scan before and after the diet to asses heart function, myocardial triglyceride content, etc. 18 months after start of the diet, patients will have an third MRI.

Our patients follow a very low calorie diet for 16 weeks. Just before and just after the diet patients will undergo a MRI. With this MRI we assess cardiac function, myocardial/hepatic triglycerides, subcutaneous and visceral fat and aortic stiffness.



The VLCD will consist of a total meal replacement (400-600 calories a day) of Prodimed. This will be expanded after 3 weeks and again after 6 weeks (guided by BMI). Participants will be seen every week to control bloodsugar, weight and bloodpressure. Participants are stimulated to continue the intervention.