Intermittent Fasting Plan with 5:2 MR approach Improves Glycemic Control in Type 2 Diabetes Patients: JAMA

A recent clinical trial published in the Journal of American Medical Association revealed that an intermittent fasting regimen, combined with meal replacement (5:2 MR), significantly improves glycemic control and promotes weight loss in patients with early type 2 diabetes. The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study was conducted across nine centers in China to compare the efficacy of the 5:2 MR diet to standard medications, metformin and empagliflozin.

This study was held from November 13, 2020 to December 29, 2022 and included a total of 509 screened patients, with 405 meeting eligibility criteria. These participants were randomly assigned to three groups, who received either metformin, empagliflozin or the 5:2 MR diet for 16 weeks, followed by an 8-week observation period. The study targeted newly diagnosed, overweight, or obese adults with type 2 diabetes to identify effective early interventions.

The participants in the 5:2 MR group followed a diet plan involving two nonconsecutive fasting days per week and were supplemented with meal replacements, while maintaining their habitual dietary intake on the remaining five days. This approach was contrasted with the conventional daily medication regimens of metformin or empagliflozin. The primary endpoint was the reduction in hemoglobin A1c (HbA1c) levels over 16 weeks. Secondary measures included changes in body weight, various anthropometric parameters and key biochemical markers. The results were analyzed to determine the comparative effectiveness of the interventions.

The study found that the 5:2 MR group expressed the most significant decrease in HbA1c levels, with a mean reduction of 1.9% (SE, 0.2%). This improvement surpassed that of the metformin group, which showed a 1.6% reduction (SE, 0.2%), and the empagliflozin group which demonstrated a 1.5% reduction (SE, 0.2%). The adjusted mean difference in HbA1c reduction between the 5:2 MR group and the medication groups was statistically significant. The 5:2 MR group achieved superior weight loss which averaged for a 9.7 kg reduction (SE, 2.2 kg) by week 16. But, the metformin group lost an average of 5.5 kg (SE, 2.3 kg) and the empagliflozin group 5.8 kg (SE, 2.3 kg).

The results of this clinical trial suggest that the 5:2 MR dietary intervention is a potential and effective strategy for managing early type 2 diabetes by offering advantages in both glycemic control and weight reduction over standard pharmaceutical treatments. This intermittent fasting approach may represent a promising alternative for early-stage diabetes management, highlighting the potential for dietary modifications to play a critical role in treating chronic conditions..

Source:

Guo, L., Xi, Y., Jin, W., Yuan, H., Qin, G., Chen, S., Zhang, L., Liu, Y., Cheng, X., Liu, W., & Yu, D. (2024). A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control for Adults With Diabetes. In JAMA Network Open (Vol. 7, Issue 6, p. e2416786). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2024.16786