Frontiers in nutrition · 2026
Diabetes-specific formula as meal replacement for individuals with type 2 diabetes mellitus and overweight or obesity: a Singapore expert consensus.
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Khoo Chin Meng, Tan Matthew, Eng Soo Kiang, Leong Choon Kit, Bee Yong Mong, Tham Kwang Wei, Bhaskaran Kalpana, Lee Yik Voon, Wong Gladys Hooi Chuan, Chan Soo Ling, Lee Phong Ching
Аннотация
INTRODUCTION: In Singapore, only one-quarter of patients with type 2 diabetes mellitus and overweight/obesity in the primary care setting are achieving clinical targets with a food-first approach to medical nutrition therapy. Diabetes-specific formula as meal replacement (DSF-MR) provides an evidence-based escalation of care but remains underutilised in practice. We developed expert consensus recommendations to support the use of DSF-MR in Singapore and across Asia.
METHODS: A multidisciplinary 11-member advisory board guided a multicomponent study that included an online healthcare professional survey, a narrative literature review, and structured consensus development. Survey insights shaped research questions and the narrative review, and collated findings were subsequently discussed at an advisory board meeting. Practical recommendations emerging from the meeting were finalised through two rounds of blinded online voting (>70% agreement) and then consolidated into a clinical algorithm for practice.
RESULTS: Eighteen practical, evidence-based recommendations achieved consensus. Collectively, they outline the clinical role of DSF-MR across three key applications: improving glycaemic control, supporting diabetes remission, and preserving muscle mass. Recommendations also address patient selection, integration within holistic care approaches, monitoring, and improving adherence, with the aim of optimising outcomes with DSF-MR.
CONCLUSION: DSF-MR is supported by evidence as a versatile dietary intervention that can be integrated across the diabetes care continuum. These expert consensus recommendations address critical gaps in current practice and provide clear and actionable guidance for the use of DSF-MR in routine diabetes care across primary care and specialist settings in Singapore.
METHODS: A multidisciplinary 11-member advisory board guided a multicomponent study that included an online healthcare professional survey, a narrative literature review, and structured consensus development. Survey insights shaped research questions and the narrative review, and collated findings were subsequently discussed at an advisory board meeting. Practical recommendations emerging from the meeting were finalised through two rounds of blinded online voting (>70% agreement) and then consolidated into a clinical algorithm for practice.
RESULTS: Eighteen practical, evidence-based recommendations achieved consensus. Collectively, they outline the clinical role of DSF-MR across three key applications: improving glycaemic control, supporting diabetes remission, and preserving muscle mass. Recommendations also address patient selection, integration within holistic care approaches, monitoring, and improving adherence, with the aim of optimising outcomes with DSF-MR.
CONCLUSION: DSF-MR is supported by evidence as a versatile dietary intervention that can be integrated across the diabetes care continuum. These expert consensus recommendations address critical gaps in current practice and provide clear and actionable guidance for the use of DSF-MR in routine diabetes care across primary care and specialist settings in Singapore.