A randomized scientific trial has been performed on Chinese language adults with early kind 2 diabetes to discover the effectiveness of an intermittent fasting meal substitute weight-reduction plan in controlling blood glucose ranges.
The research is printed in JAMA Community Open.
Background
Sort 2 diabetes has turn into a significant public well being disaster worldwide. In keeping with the Worldwide Diabetes Federation report printed in 2021, about 537 million adults are residing with kind 2 diabetes globally.
China has the very best prevalence of diabetes on the earth. The nation has witnessed a 56.6% improve in diabetic adults between 2011 and 2021. The present prevalence of diabetes in China is 12.4%. Furthermore, about 50% of the Chinese language basic inhabitants is both obese or overweight.
Weight problems and obese are the foremost threat elements for diabetes improvement. It has been noticed that an enchancment in glycemic management and a discount in antidiabetic drug dosage may be achieved via physique weight discount.
Meal substitute is a helpful weight reduction technique whereby a prepackaged meals or beverage is substituted for a number of meals. Current randomized scientific trials have proven that meal substitute is simpler than different diets in reaching weight reduction.
On this randomized scientific trial, scientists have investigated whether or not a mix of a 5:2 intermittent fasting weight-reduction plan and a meal substitute weight-reduction plan can successfully management blood glucose ranges and cut back physique weight in overweight or obese Chinese language adults with early kind 2 diabetes.
The 5:2 intermittent fasting weight-reduction plan includes two nonconsecutive fasting days (one-fourth of the vitality consumption of a routine weight-reduction plan) and 5 days of routine consumption per week.
Examine design
This randomized scientific trial was performed on a complete of 405 Chinese language adults with newly recognized kind 2 diabetes who had not used any antidiabetic or weight-loss medicine previously three months.
The individuals have been randomly categorized into three teams, every receiving both metformin, empagliflozin, or 5:2 meal substitute. The remedy lasted for 16 weeks.
The individuals within the 5:2 meal substitute group consumed one serving of a low-energy product as an alternative of all three common meals for 2 nonconsecutive days. On the remaining 5 days, they consumed breakfast and lunch in line with their alternative however had one serving of a meal substitute product for dinner.
Parameters analyzed after the top of the 16-week remedy interval included glycated hemoglobin (a measure of glycemic management), physique weight, anthropometric parameters, and biochemical parameters.
Vital observations
The best discount in glycated hemoglobin stage was noticed within the 5:2 meal substitute group in comparison with that within the metformin group and empagliflozin group. Nonetheless, no vital distinction in glycated hemoglobin stage was noticed between metformin-treated and empagliflozin-treated sufferers.
Aside from sufferers aged 60 years or above, the development in glycemic management as a consequence of 5:2 meal substitute was noticed throughout all individuals, together with overweight or obese sufferers.
The proportion of sufferers reaching glycated hemoglobin ranges of lower than 7% or 6.5% was considerably larger within the 5:2 meal substitute group in comparison with that within the metformin and empagliflozin teams.
About 76% of individuals within the 5:2 meal substitute group maintained a glycated hemoglobin stage of lower than 6.5% at 8 weeks post-treatment. Fasting blood glucose stage was additionally diminished by 30.3 mg/dL within the 5:2 meal substitute group.
A considerably larger discount in physique weight, waist and hip circumference, and systolic and diastolic blood strain was noticed within the 5:2 meal substitute group in comparison with that within the different two teams.
Concerning security profile, the 5:2 meal substitute was discovered to trigger constipation in a single affected person and hypoglycemia in 8 sufferers, which might be as a consequence of a low-energy weight-reduction plan.
Within the metformin group, 26 sufferers skilled gentle gastrointestinal signs, and eight sufferers had hypoglycemia. Within the empagliflozin group, three sufferers skilled urinary signs, 5 sufferers had hypoglycemia, and one affected person reported feeling thirsty.
Extreme antagonistic occasions, together with extreme rash and hospitalization as a consequence of elevated blood ketone ranges, have been noticed in two sufferers within the empagliflozin group. Nonetheless, these problems resolved after remedy.
Examine significance
The research finds {that a} 5:2 meal substitute technique for 16 weeks can successfully enhance glycemic management and cut back physique weight in overweight or obese Chinese language people with newly recognized kind 2 diabetes.
This dietary intervention displays larger efficacy in managing diabetes and weight problems than two antidiabetic medicine, metformin and empagliflozin.
The research was performed on diabetic sufferers who weren’t taking any antidiabetic medicine and had a glycated hemoglobin stage of lower than 9% at baseline. Furthermore, the research interventions have been carried out for a brief length. Thus, future research are wanted to find out the long-term efficacy of a 5:2 meal substitute weight-reduction plan in sufferers receiving antidiabetic medicine and having larger baseline glycated hemoglobin ranges.
General, the research findings counsel that the 5:2 meal substitute technique could also be an efficient preliminary way of life intervention for early managing kind 2 diabetes.
