Lew LC, Mat Ludin AF, Abdul Manaf Z, Mohd Tohit N, Shahar S. Mapping evidence and identifying risks: A systematic scoping review of meal replacements in type 2 diabetes. World J Diabetes 2025; 16(8): 104371 [DOI: 10.4239/wjd.v16.i8.104371]
Corresponding Author of This Article
Arimi Fitri Mat Ludin, PhD, Associate Professor, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Kuala Lumpur, Malaysia. arimifitri@ukm.edu.my
Research Domain of This Article
Nutrition & Dietetics
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Aug 15, 2025; 16(8): 104371 Published online Aug 15, 2025. doi: 10.4239/wjd.v16.i8.104371
Mapping evidence and identifying risks: A systematic scoping review of meal replacements in type 2 diabetes
Leong Chen Lew, Arimi Fitri Mat Ludin, Zahara Abdul Manaf, Noorlaili Mohd Tohit, Suzana Shahar
Leong Chen Lew, Arimi Fitri Mat Ludin, Zahara Abdul Manaf, Suzana Shahar, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Kuala Lumpur, Malaysia
Leong Chen Lew, Arimi Fitri Mat Ludin, Biomedical Science Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Kuala Lumpur, Malaysia
Zahara Abdul Manaf, Suzana Shahar, Dietetic Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Kuala Lumpur, Malaysia
Noorlaili Mohd Tohit, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Kuala Lumpur, Malaysia
Author contributions: Mat Ludin AF and Lew LC conceived the review; Shahar S, Abdul Manaf Z and Mohd Tohit N contributed to framing the topic and keywords and clarifying inclusion and exclusion criteria for the systematic database search; Mat Ludin AF and Lew LC conducted the literature searches in parallel; Mat Ludin AF and Lew LC screened and extracted the titles and full texts in consultation with Shahar S, Abdul Manaf Z, Mohd Tohit N; Shahar S, Abdul Manaf Z and Mohd Tohit N checked the extracted data for accuracy; All researchers discussed any discrepancies and all authors contributed to collating and interpreting of findings, prepared the draft and approved the final version for submission.
Conflict-of-interest statement: The authors declare that they have no conflict of interests to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arimi Fitri Mat Ludin, PhD, Associate Professor, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Kuala Lumpur, Malaysia. arimifitri@ukm.edu.my
Received: December 19, 2024 Revised: April 8, 2025 Accepted: July 10, 2025 Published online: August 15, 2025 Processing time: 238 Days and 18.2 Hours
Abstract
BACKGROUND
Type 2 diabetes (T2D) is a major health concern globally and its prevalence is expected to continue to escalate. Lifestyle intervention is an integral part of T2D management. Meal replacements are often used as part of lifestyle intervention programs in T2D and weight management programs. There are various trials being carried out to date; however, a thorough review regarding the usage of meal replacement on its types, dosage and associated outcomes and adverse events is still lacking.
AIM
To provide a comprehensive overview on existing studies regarding meal replacement usage among patients with T2D, and map out glycemic and weight-related outcomes along with adverse effects incidences.
METHODS
This scoping review is conducted based on Arksey and O’Malley’s seminal framework for scoping reviews. A systematic search has been done for studies published between January 2020 and January 2024 across six online databases (Cochrane Library, PubMed, Science Direct, Scopus, Web of Science and Ebscohost Discovery) using specific keywords. Two researchers independently assessed the eligibility of the studies and extracted the data. The selected articles and extracted data were reviewed by all researchers.
RESULTS
The initial search resulted in an initial count of 53922 articles from which 133 articles were included in this review after eligibility screening. Included studies were categorized based on meal replacement type into low calorie/energy, low glycemic index, protein-rich, low-fat, diabetes-specific formulas, and combined lifestyle intervention programs. Fifty-nine studies reported improvements on hemoglobin A1c, and 70 studies reported positive changes in weight or BMI after the meal replacement intervention. The combination of meal replacements with education, counseling or structured lifestyle interventions has proved to be effective. Only 13 studies reported occurrence of adverse events related to the intervention. Most of the reported incidents were of mild occurrences with constipation being the most reported adverse event.
CONCLUSION
The results suggest that meal replacements, especially when combined with lifestyle intervention programs and counseling, are an effective and safe strategy in glycemic and weight management among patients with T2D.
Core Tip: This scoping review systematically evaluated meal replacement interventions in type 2 diabetes, focusing on their effects on glycemic and weight management, as well as associated risks. Key findings included significant improvements in hemoglobin A1c and body mass index after meal replacement interventions, with notable efficacy when combined with lifestyle programs. Most reported adverse events were mild. The review categorized existing studies by meal replacement type and dosage, providing comprehensive insights for tailoring interventions in clinical practice. These results emphasize meal replacements as a promising tool in diabetes management, with implications for improving patient outcomes and reducing healthcare burdens.
