Effect of an Intermittent Calorie-restricted Diet on Type 2 Diabetes Remission: A Randomized Controlled Trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 36515429 · doi:10.1210/clinem/dgac661
What was done
A randomized controlled trial evaluated 72 adults aged 38–72 with type 2 diabetes (duration 1–11 years, BMI 19.1–30.4, taking antidiabetic agents and/or insulin) allocated 1:1 to an intermittent calorie-restricted diet (Chinese Medical Nutrition Therapy, CMNT) or a control group. The primary outcome was diabetes remission, defined as stable HbA1c < 6.5% (< 48 mmol/mol) for at least 3 months after stopping all antidiabetic medications, assessed after a 3-month intervention plus 3-month follow-up, with durability tracked through 12 months. Secondary outcomes included weight, HbA1c, fasting glucose, blood pressure, quality of life, and medication costs.
What was found
After the 3-month intervention plus 3-month follow-up, 47.2% (17/36) of participants achieved diabetes remission in the CMNT group compared to 2.8% (1/36) in the control group (OR 31.32; 95% CI, 2.39–121.07; P < 0.0001). Mean body weight decreased by 5.93 kg (SD 2.47) in the CMNT group versus 0.27 kg (SD 1.43) in controls. At 12 months, 44.4% (16/36) of CMNT participants sustained remission (mean HbA1c 6.33%, SD 0.87). Monthly medication costs were 77.22% lower in the CMNT group (60.4/month vs 265.1/month).
Why it matters
This study provides randomized evidence that an intermittent calorie-restriction protocol can achieve durable, medication-free type 2 diabetes remission for at least 1 year in a substantial proportion of patients, alongside major medication cost reductions.
Limits
The sample size was small (n = 72), producing wide confidence intervals for the primary effect. Specifics of the control group regimen, blinding, and adverse events were not described in the abstract. Participants had a BMI range of 19.1 to 30.4, which may limit generalizability to more severely obese populations.
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