2632-P: Cardiovascular Risk Factors, Inflammation, Incretin Improvements and Remission of Type 2 Diabetes with High-Protein Weight Loss Program

Introduction and Objective: The incretin GLP-1 and GIP agonists have been shown to be effective in pharmacological treatment for weight loss and Type 2 Diabetes (T2D). Therefore, we studied the effects of a High Protein Weight Loss Diet Program)(HPWLDP)(HP) on incretin level changes, remission of T2D, improvement in Cardiovascular Risk Factors (CVRF) and inflammation (IC) and muscle mass preservation (LM) in 24 obese women and men age 21-60 years with T2D. Methods: Subjects were randomized to a HP(30% protein,30% fat, 40%CHO) or High Carbohydrate Weight Loss Diet Program(HCWLDP)(HC)(15% protein, 30% fat, 55% carbohydrates) for 6 months(mo). All food provided weekly along with weight monitor. Caloric need for weight loss was determined by Resting Metabolic Rate-500 calories/day. OGTT were performed at Baseline(BL) and 6 mo to determine T2D or Normal Glucose Tolerance (NGT) status. GLP-1 and GIP levels were determined with a Meal Tolerance Test (MTT) at BL and after 6 mo on HP and HC. CVRF B-Type Natriuretic Peptide(BNP) released from the heart and DXA were determined at BL and 6 mo. Results: T2D subjects on HP had 100% remission to NGT while HC subjects had 16% remission. IC were significantly decreased in HP compared to HC subjects at 6 mo(TNFa[HP- 3.9 vs HC- 12.6]). HP had greater improvement in insulin sensitivity: HOMA IR [HP(BL- 5.3; 6 mo- 2.1)], and decrease in HbA1c [HP(BL- 7.7; 6 mo-5.6)], HP group had a 2.7% increase in lean mass(LM) and 2.9% decrease in fat mass(FM) compared to HC group had a decrease in LM (1.9%) and FM (3.3%). HP had a significantly greater increase in GLP-1 from BL to 6 mo (23.9 to 30.4) than HC and HP GIP greater increase (18.2 to 24.8) than HC. Decrease in HP BNP(163 to 59) demonstrates CVRF improvement in with HP. Conclusion: HP demonstrated improvement in GLP-1 and GIP release and insulin sensitivity with 100% remission of T2D to NGT, maintenance of LM with decreased FM and significant decrease in IC. HP diet foods can be obtained at local grocery stores for $15/day providing an affordable meal plan for low income subjects. Disclosure F.B. Stentz: None. A. Ammons: None. Funding AD BASKIN Research Grant