The VLCD consisted of 2 commercially available meal replacements (Glucerna SR®) per day plus 75 g of lean meat, 150 ml of skimmed milk, and lowcarbohydrate vegetables ad libitum. Subsequently, participants followed a low-calorie diet of 1100e1300 kcal/day for another 12 weeks. After 20 weeks, the participants used a 1300 kcal/day diet based on national health recommendations. During the diet program,60minofdailyexercisewasencouraged.Toreducetheriskof hypoglycemia, the doses of sulfonylurea-derivatives and insulin were lowered before start of the dietary intervention but after baseline measurements. During the dietary intervention, insulin dose was adjusted based on glucose levels. Since insulin was adjusted during the intervention,