Application of Time Restriction Feeding in Patients With Type 2 Diabetes Mellitus
Study Details
Study Description
Brief Summary
In this 3-week interventional study, the investigators hypothesize that therapeutic Time-Restricted Feeding in patients with poorly controlled Type 2 diabetes mellitus (T2DM) can improve their mean glucose or estimated glycated hemoglobin levels with the same dose, or even reduced dose, of antidiabetics.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
Time-restricted feeding (TRF) has recently gained popularity as a means of reducing body weight and improving glycemia. A recent clinical trial in men who had prediabetes showed that TRF for five weeks significantly reduced fasting insulin concentration and improved the derived oral glucose tolerance test ( OGTT) indexes of beta-cell responsiveness and insulin resistance. However, the effects of TRF have not been studied in patients with poorly controlled Type 2 diabetes mellitus (T2DM). In this 3-week interventional self-controlled clinical trial, the investigators hypothesize that TRF in patients with poorly-controlled T2DM can improve their mean glucose with the same dose/reduced dose of antidiabetics. Potential study subjects will be identified from Endocrinology clinic patients with a diagnosis of poorly controlled type 2 DM (A1c >= 8.0 in the 3 months before enrollment) based on inclusion and exclusion criteria. All study subjects will be in the ad libitum feeding phase for one week, and then will be placed on time-restricted fasting (feeding between 4 AM
- 4 PM, fasting in the rest of the day) for the second week. For the third and final week, patients will be returned to the ad libitum feeding phase. The first and third weeks will serve as the control phases, and the second week will be the experimental phase. The mean glucose, serum triglyceride levels, insulin resistance, and body weights will be compared between the two phases. Results of this clinical study may demonstrate a low-cost and practical way of diabetic control.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Time restricted feeding The study will consist of three phases. In phase I all study subjects will be in the ad libitum feeding phase for one week followed by Phase II. In Phase II the subjects will be placed on time-restricted fasting (feeding between 4 AM - 4 PM, fasting in the rest of the day) for one week. For phase III (final week), patients will be returned to an ad libitum feeding. The first and third phases will serve as control phases, and the second phase will be the experimental phase |
Behavioral: Time restricted feeding
In Phase II the study subjects will be placed on time-restricted fasting (feeding between 4 AM - 4 PM, fasting in the rest of the day) for one week.
Other Names:
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Outcome Measures
Primary Outcome Measures
- mean glucose [in one week of time restricted feeding]
change in mean glucose
- estimated hemoglobin A1c levels [in one week of time restricted feeding]
change in estimated hemoglobin A1c levels
Secondary Outcome Measures
- Insulin resistance [in one week of time restricted feeding]
change in Insulin resistance is represented by the homeostatic model of assessment of insulin resistance
- serum triglyceride levels [in one week of time restricted feeding]
change serum triglycerides are measured by a fasting lipid panel
- body weight [in one week of time restricted feeding]
change in body weight
Eligibility Criteria
Criteria
Inclusion Criteria:
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Age ≥ 18 years and < 65 years
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With the diagnosis of type 2 diabetes
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A1c >= 8.0 on the most recent test in the 3 months before enrollment
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Have been on stable antidiabetics in the 3 months before enrollment
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OhioHealth Patient
Exclusion Criteria:
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Pregnant or breastfeeding patients
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Severe hypoglycemic episodes (defined as having low blood glucose levels that requires assistance from another person to treat) in the past 12 months
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Unable to give informed consent
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Currently enrolled in another therapeutic study
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Thyroid dysfunction, as defined by abnormal thyroid function test results within the past 6 months
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Advanced stage of renal (stage 4 or above) or hepatic (cirrhosis) or respiratory (needs oxygen) or heart failure (NYHA class 3 or above)
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Active infection or malignancy
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Dementia, or other significant mental impairment that would, in the opinion of the investigator, impede patient self-reporting
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Clinician-reported history of patient non-adherence
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | OhioHealth Castrop Health Center | Athens | Ohio | United States | 45701 |
Sponsors and Collaborators
- OhioHealth
- Ohio University
Investigators
- Principal Investigator: Yuanjie Mao, MD, PhD, OhioHealth
Study Documents (Full-Text)
None provided.More Information
Publications
- Barnosky AR, Hoddy KK, Unterman TG, Varady KA. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl Res. 2014 Oct;164(4):302-11. doi: 10.1016/j.trsl.2014.05.013. Epub 2014 Jun 12. Review.
- Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab. 2018 Jun 5;27(6):1212-1221.e3. doi: 10.1016/j.cmet.2018.04.010. Epub 2018 May 10.
- Zubrzycki A, Cierpka-Kmiec K, Kmiec Z, Wronska A. The role of low-calorie diets and intermittent fasting in the treatment of obesity and type-2 diabetes. J Physiol Pharmacol. 2018 Oct;69(5). doi: 10.26402/jpp.2018.5.02. Epub 2019 Jan 21. Review.
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