Intermittent energy restriction can better aid in diabetes control among obese — Study

NEW DELHI — Dietary approaches like intermittent energy restriction, time-restricted eating, and continuous energy restriction can all improve blood sugar levels and body weight in people with obesity and type 2 diabetes, according to a study.

Although researchers identified improved HbA1c levels, and adverse events were similar across the three groups, the IER group showed greater advantages in reducing fasting blood glucose, improving insulin sensitivity, lowering triglycerides, and strengthening adherence to the dietary interventions.

IER typically involves periods of reduced calorie intake. It differs from intermittent fasting (IF) as it involves periods of complete or near-complete food abstinence.

The research directly compared 5:2 intermittent energy restriction with 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 Haohao Zhang, Ph.D., chief physician at The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China.

The study involved 90 patients who were randomly assigned in a 1:1:1 ratio to the IER, TRE, or CER group, with consistent weekly caloric intake across all groups. A team of nutritionists supervised the 16-week intervention.

Of those enrolled, 63 completed the study. There were 18 females and 45 males, with an average age of 36.8 years, a mean diabetes duration of 1.5 years, a baseline BMI of 31.7 kg/m², and an HbA1c of 7.42 per cent.

At the end of the study, there were no significant differences in HbA1c reduction and weight loss between the IER, TRE, and CER groups. However, the absolute decrease in HbA1c and body weight was greatest in the IER group.

Compared to TRE and CER, IER significantly reduced fasting blood glucose and triglycerides and increased the Matsuda index, a measure of whole-body insulin sensitivity. Uric acid and liver enzyme levels exhibited no statistically significant changes from baseline in any study group.

Two patients in the IER group and the TRE group, and three patients in the CER group, experienced mild hypoglycemia.

The IER group had the highest adherence rate (85 per cent), followed by the CER group at 84 per cent and the TRE group at 78 per cent. Both the IER and CER groups showed statistically significant differences compared with the TRE group.

Zhang said these findings highlight the feasibility and effectiveness of dietary interventions for people who have obesity and type 2 diabetes.

The study is presented at the ongoing ENDO 2025, the Endocrine Society's annual meeting in San Francisco, US.