The effects of intermittent compared to continuous energy restriction on glycaemic control in type 2 diabetes; a pragmatic pilot trial.
OBJECTIVE
Weight loss improves glycaemic control in type 2 diabetes mellitus (T2DM). However, as achieving and maintaining weight loss is difficult, alternative strategies are needed. Our primary aim was to investigate the effects of intermittent energy restriction (IER) compared to continuous energy restriction (CER) on glycated haemoglobin A1c (HbA1c). Secondary aims were to assess effects on weight loss, body composition, medication changes and subjective measures of appetite. Using a 2-day IER method, we expected equal improvements to HbA1c and weight in both groups.


METHODS
Sixty-three overweight or obese participants (BMI 35.2±5kg/m2) with T2DM (HbA1c 7.4±1.3%) (57mmol/mol) were randomised to a 2-day severe energy restriction (1670-2500kJ/day) with 5days of habitual eating, compared to a moderate CER diet (5000-6500kJ/day) for 12weeks.


RESULTS
At 12weeks HbA1c (-0.7±0.9% P<0.001) and percent body weight reduction (-5.9±4% P<0.001) was similar in both groups with no group by time interaction. Similar reductions were also seen for medication dosages, all measures of body composition and subjective reports of appetite.


CONCLUSIONS
In this pilot trial, 2days of IER compared with CER resulted in similar improvements in glycaemic control and weight reduction offering a suitable alternative treatment strategy.
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
S
S
Carter
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia. Electronic address: peter.clifton@unisa.edu.au.
P M
PM
Clifton
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
J B
JB
Keogh
D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D031204:Caloric Restriction / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology; D010865:Pilot Projects; D015431:Weight Loss
D001786:Blood Glucose; D006442:Glycated Hemoglobin
Energy restriction; Intermittent; Intermittent dieting; Intermittent energy restriction; Intermittent fasting; Type 2 diabetes