A randomized noninferiority trial in Australia suggested that intermittent energy restriction is an effective alternative diet strategy for the reduction of hemoglobin A1c (HbA1c) level comparable to continuous energy restriction in patients with type 2 diabetes (T2D), and it may be superior to continuous energy restriction for weight loss. The trial included 137 participants (77 women, mean age 61.0 years, mean body mass index 36.0, and mean HbA1c level 7.3%), 97 completed the trial. Randomized interventions were an intermittent energy restriction diet (500-600 kcal/d) for 2 nonconsecutive days per week with usual diet for the other 5 days or a continuous energy restriction diet (1200-1500 kcal/d) for 7 days per week for 12 months. Intention-to-treat analysis showed similar reductions in mean HbA1c level between the continuous and intermittent energy restriction groups with a between-group difference of 0.2%, meeting the criteria for equivalence. Mean weight change was similar (–5.0 vs –6.8 kg), but the between-group difference (–1.8 kg) did not meet the criteria for equivalence, nor did the between-group difference in fat mass (–1.3 kg) or fat-free mass (–0.5 kg). There were no significant differences between groups in final step count, fasting glucose levels, lipid levels, or total medication effect score at 12 months. Effects did not differ using completers analysis. Hypoglycemic or hyperglycemic events in the first 2 weeks of treatment were similar between the groups, affecting 35% of participants (16 of 46) using sulfonylureas and/or insulin. The findings suggest that intermittent energy restriction is effective and safe for most patients with T2D who are not using glycemic agents likely to cause hypoglycemia. However, for patients using sulfonylureas and/or insulin, regular monitoring is paramount. Previous studies have shown that intermittent energy restriction is effective for weight loss comparable to continuous energy restriction. Source: https://jamanetwork.com/
