Twice-weekly energy-restricted diet tops exercise to lower blood sugar in type 2 diabetes: Study

The study revealed that the medically supervised 5:2 energy-restricted diet could be an alternative strategy for improving glycemic control, and the exercise regimen could improve body composition, although it inadequately improved glycemic control.

Type 2 diabetes, a chronic metabolic disorder characterized by insulin resistance and hyperglycemia, poses a formidable public health challenge worldwide, with obesity emerging as a major predisposing factor. While lifestyle modifications, including diet and exercise, are cornerstone strategies in diabetes management, the optimal regimen for achieving glycemic control and reducing cardiovascular risk remains a subject of ongoing debate.

Mian Li, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and colleagues aimed to investigate the effects of a 5:2 regimen diet (2 days per week of energy restriction by formula diet) or an exercise (2 days per week of high-intensity interval training and resistance training) intervention versus routine lifestyle education (control) on cardiometabolic health and glycemic control among adults with overweight/obesity and type 2 diabetes.

For this purpose, the researchers conducted a two-center, open-label, three-arm, parallel-group, randomized controlled trial that recruited 326 participants with obesity/overweight and type 2 diabetes. They were randomized into 12 weeks of diet intervention (n = 109), exercise intervention (n = 108), or lifestyle education (control) (n = 109).

The study's primary outcome was the glycemic control change measured as glycated hemoglobin (HbA1c) between the diet or exercise intervention groups and the control group after the 12-week intervention.

Based on the study, the researchers reported the following findings:

• The diet intervention significantly reduced HbA1c level (%) after the 12-week intervention (−0.72) compared with the control group (−0.37) (diet versus control −0.34).
• The reduction in HbA1c level in the exercise intervention group (−0.46) did not significantly differ from the control group (exercise vs. control −0.09).
• The exercise intervention group was superior in maintaining lean body mass.
• Both diet and exercise interventions induced improvements in adiposity and hepatic steatosis.

The findings showed that two days a week of a medically supervised energy-restricted diet may lower blood glucose levels in adults with overweight or obesity and type 2 diabetes.

"The diet intervention group experienced a greater energy deficit with a more pronounced metabolic benefit," the researchers wrote. "Our study indicates that a medically supervised 5:2 energy-restricted diet could be an alternative strategy for improving glycemic control."

Reference:

Mian Li, Jie Li, Yu Xu, Jinli Gao, Qiuyu Cao, Yi Ding, Zhuojun Xin, Ming Lu, Xiaoting Li, Haihong Song, Jue Shen, Tianzhichao Hou, Ruixin He, Ling Li, Zhiyun Zhao, Min Xu, Jieli Lu, Tiange Wang, Shuangyuan Wang, Hong Lin, Ruizhi Zheng, Jie Zheng, Callum John Baker, Shenghan Lai, Nathan Anthony Johnson, Guang Ning, Stephen Morris Twigg, Weiqing Wang, Yan Liu, Yufang Bi; Effect of 5:2 Regimens: Energy-Restricted Diet or Low-Volume High-Intensity Interval Training Combined With Resistance Exercise on Glycemic Control and Cardiometabolic Health in Adults With Overweight/Obesity and Type 2 Diabetes—A Three-Arm Randomized Controlled Trial. Diabetes Care 2024; dc240241. https://doi.org/10.2337/dc24-0241