Daily Low-Glycemic Formula Drink Improved Blood Sugar Control in Thai Adults with Type 2 Diabetes

Adults with type 2 diabetes in Thailand who added one daily serving of a low-glycemic-index diabetes-specific formula to standard nutrition counseling saw a modest but statistically significant improvement in their long-term blood sugar control over 90 days, according to a randomized controlled trial published in BMC Nutrition. The finding addresses a gap in evidence, since most research on diabetes-specific formulas has come from outside Asian outpatient settings, where dietary patterns differ markedly.

The trial enrolled 102 adults with type 2 diabetes, aged 35 to 75 years. Participants were randomly assigned in equal numbers to two groups. The control group, comprising 51 people, received standard nutrition advice alone. The intervention group, also 51 people, received the same standard advice plus a once-daily meal replacement using a diabetes-specific formula marketed as D-care, which has a glycemic index of 26, a value classified as low. The study ran for 90 days and was registered in advance with the Thai Clinical Trials Registry under identifier TCTR20230122001 on 22 January 2023.

The researchers evaluated outcomes using linear mixed-effects models, a statistical approach that allowed them to assess the effects of time, group assignment, and the interaction between the two.

The headline result concerned glycated hemoglobin, or HbA1c. Compared with the control group, the intervention group showed a significantly greater reduction in HbA1c, with an adjusted mean difference of minus 0.34 percentage points and a 95 percent confidence interval of minus 0.6 to minus 0.1, yielding a p-value of 0.020.

The intervention group also showed reductions in fasting blood glucose, triglycerides, body weight, and daily energy intake. However, the trial authors report that these changes were not significantly different between the two groups. In other words, while the formula group moved in a favorable direction on several metabolic markers, the study could not distinguish those changes from what standard nutrition advice alone achieved. This distinction matters for interpreting the results: the clearest, statistically supported effect of the once-daily formula was on HbA1c, not on the broader set of metabolic parameters.

The rationale behind the intervention rests on the role of refined carbohydrates in Asian diets. The study’s background notes that type 2 diabetes is a major and growing health burden in Asia, and that maintaining glycemic control remains difficult because of high refined carbohydrate consumption and rapid dietary transitions across the region.

The authors conclude that once-daily use of a low-glycemic diabetes-specific formula as part of standard nutritional counseling was associated with improved glycemic control in Thai adults with type 2 diabetes, and they suggest the strategy may represent a practical dietary approach for diabetes management in Asian populations. The wording is deliberately cautious: as a randomized controlled trial measuring associations over a fixed 90-day window, the study supports a short-term effect on glycemic control rather than claims about long-term outcomes such as complications or disease progression.

Several limitations frame how far the findings can be generalized. The trial involved a single formula product, a specific dose of one meal replacement per day, and a Thai outpatient population over a relatively short duration. Whether similar benefits would extend to other populations, other formulations, longer periods of use, or different baseline levels of glycemic control was not tested. The published version of the article is an open-access early-release record, citable with a permanent DOI, subject to further editorial updates before the final version of record appears. Readers weighing the results for personal dietary decisions should note that the intervention was delivered alongside professional nutrition counseling, not as a substitute for it, and that the trial’s significant finding was confined to HbA1c.

Subject of Research: A randomized controlled trial of a low-glycemic-index diabetes-specific formula used as a once-daily meal replacement for glycemic control in Thai adults with type 2 diabetes.

Article Title: Efficacy of a diabetes-specific formula used as a meal replacement in the management of type 2 diabetes: a randomized controlled trial

Article References: Chupisanyarote, K., Srikhajonjit, W., Kullavanijaya, N., Srichan, C., Tonglim, J., & Wichansawakun, S. (2026). Efficacy of a diabetes-specific formula used as a meal replacement in the management of type 2 diabetes: a randomized controlled trial. BMC Nutrition. https://doi.org/10.1186/s40795-026-01532-9

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DOI: 10.1186/s40795-026-01532-9

Keywords: type 2 diabetes, diabetes-specific formula, meal replacement, glycemic index, HbA1c, randomized controlled trial, Thailand, nutrition counseling, glycemic control, metabolic parameters, Efficacy, diabetes-specific