[A case of severe obese patient complicated with type-2 diabetes--transition from Very Low Calorie Diet(VLCD) therapy to Low Calorie Diet(LCD)therapy].

A 6 0-year-old woman with severe obese and type-2 diabetes was hospitalized due to poorly controlled glycemia by worsening osteoarthritis of both knees. Although a diet therapy(1,200 kcal/day)was initially offered, but the body weight did not decrease. Thus, we changed VLCD therapy to LCD therapy sequentially. The weight loss made her possible not only to walk with a walker but it also improved a glycemic control. Because it was thought to be necessary to reduce her economic burden in order to continue the LCD therapy after was discharged, an inexpensive LCD menu was devised based on meal and auxiliary nutrients including trace elements. To support the LCD therapy at home, it is important to propose a simple and sustainable approach with a consideration of economic aspects as well as home environment.

[The use of total enteral formula with enriched nutrient in home Low Calorie Diet(LCD)therapy based on regular meal].

We made a low calorie diet(LCD)menu which added two commercial supporting nutritional supplements to a meal. Because a conventional formula food is very expensive, the patient was not able to afford it at home. Those supplements are a total enteral formula with enriched nutrient(ACURE EN800)and vitamin-mineral rich drink(V CRESC). The contents of vitamin and mineral in this menu satisfied the dietary reference intakes, though protein was a little low. However, we could keep the price low compared to the formula food. The patient was able to switch over to home LCD therapy with the menu.