Which Diet Strategy Best Suits T2D Care in Obesity?
Patients with obesity and type 2 diabetes (T2D) achieved similar improvements in A1c levels and weight loss with intermittent energy restriction, time-restricted eating, and continuous energy restriction; however, intermittent fasting provided additional benefits in lowering fasting blood glucose and triglyceride levels, improving insulin sensitivity, and increasing patient adherence.
METHODOLOGY:
The 5:2 intermittent fasting method, which involves eating normally for 5 days and restricting calories for 2 days each week, has shown effectiveness in weight management and blood glucose control; however, its direct comparison with 10-hour time-restricted eating in patients with obesity and T2D remains unclear.
Researchers in China conducted a single-center, randomized trial between November 2021 and November 2024 to compare the effects of three different dietary interventions in patients with obesity and T2D.
They randomly assigned 90 patients in a 1:1:1 ratio to one of three groups — intermittent energy restriction, time-restricted eating, or continuous energy restriction — with a similar weekly intake of calories across all groups.
A nutritionist provided supervision and guidance for the interventions over 16 weeks.
The primary endpoint was a change in A1c levels, and secondary endpoints included various laboratory parameters, adverse events, and patient adherence.
TAKEAWAY:
The 16-week intervention was completed by 63 patients including 18 women (average age, 36.8 years; baseline BMI, 31.7; A1c level, 7.42%). Adherence was highest with intermittent energy restriction (85%), followed by continuous energy restriction (84%) and time-restricted eating (78%).
After 16 weeks, A1c levels were reduced by 1.03%-1.56% and weight reduced by 5.7-8.6 kg across all three groups; although no significant differences were found between the groups, the intermittent energy restriction group showed the greatest absolute changes.
Compared with the other two interventions, intermittent energy restriction resulted in significantly lower fasting glucose and triglyceride levels (by an average of 2.3 mmol/L and 1.139 mmol/L, respectively) and improved insulin sensitivity (Matsuda index, 80.23; P < .05 for all).
Hypoglycemia occurred in two patients each in the intermittent energy restriction and time-restricted-eating groups and three patients in the continuous energy restriction group.
IN PRACTICE:
'The research fills a gap in directly comparing 5:2 intermittent energy restriction with a 10-hour time-restricted eating in patients with obesity and type 2 diabetes. The findings provide scientific evidence for clinicians to choose appropriate dietary strategies when treating such patients,' said the lead author in a news release.
SOURCE:
This study was led by Haohao Zhang, PhD, The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China. It was presented on July 13, 2025, at the ENDO 2025: The Endocrine Society Annual Meeting, in San Francisco.
LIMITATIONS:
This study did not report any specific limitations.
DISCLOSURES:
This study did not report any specific funding or conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
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