Three weeks of time-restricted eating improves glucose homeostasis in adults with type 2 diabetes but does not improve insulin sensitivity: a randomised crossover trial
Andriessen C, Fealy CE, Veelen A, van Beek SMM, Roumans KHM, Connell NJ, Mevenkamp J, Moonen-Kornips E, Havekes B, Schrauwen-Hinderling VB, Hoeks J, Schrauwen P
Diabetologia · 98 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- ZonMw
- Nonprofit
- Diabetes Fonds
- Nonprofit
- European Association for the Study of Diabetes
Based on 3 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2022-07-24 · Diabetologia · vol. 65 · issue 10 · pp. 1710–1720
- Publisher
- Springer Science+Business Media
- Cited
- 128 citations · more than 99% of similar papers · 11.3× the field average
- Impact
- Top 10% most cited in its field
- References
- 32 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Dietary Effects on Health · Enhanced Recovery After Surgery · Circadian rhythm and melatonin
- Keywords
- Glucose homeostasis, Crossover study, Medicine, Human physiology, Insulin sensitivity, Type 2 diabetes, Randomized controlled trial, Diabetes mellitus, Insulin, Internal medicine, Endocrinology, Homeostasis, Insulin resistance, Alternative medicine
- MeSH
- humans, diabetes mellitus, type 2, insulin resistance, liver glycogen, insulin, glucose, blood glucose, lipids, blood glucose self-monitoring, cross-over studies, homeostasis, adult
12 authors
From NL
- Charlotte AndriessenMaastricht University
- Ciarán E. FealyMaastricht University
- Anna VeelenMaastricht University
- Sten M. M. van BeekMaastricht University
- Kay H. M. RoumansMaastricht University
- Niels J. ConnellMaastricht University
Abstract
Aims/hypothesis
Time-restricted eating (TRE) is suggested to improve metabolic health by limiting food intake to a defined time window, thereby prolonging the overnight fast. This prolonged fast is expected to lead to a more pronounced depletion of hepatic glycogen stores overnight and might improve insulin sensitivity due to an increased need to replenish nutrient storage. Previous studies showed beneficial metabolic effects of 6-8 h TRE regimens in healthy, overweight adults under controlled conditions. However, the effects of TRE on glucose homeostasis in individuals with type 2 diabetes are unclear. Here, we extensively investigated the effects of TRE on hepatic glycogen levels and insulin sensitivity in individuals with type 2 diabetes.
Methods
Fourteen adults with type 2 diabetes (BMI 30.5±4.2 kg/m2, HbA1c 46.1±7.2 mmol/mol [6.4±0.7%]) participated in a 3 week TRE (daily food intake within 10 h) vs control (spreading food intake over ≥14 h) regimen in a randomised, crossover trial design. The study was performed at Maastricht University, the Netherlands. Eligibility criteria included diagnosis of type 2 diabetes, intermediate chronotype and absence of medical conditions that could interfere with the study execution and/or outcome. Randomisation was performed by a study-independent investigator, ensuring that an equal amount of participants started with TRE and CON. Due to the nature of the study, neither volunteers nor investigators were blinded to the study interventions. The quality of the data was checked without knowledge on intervention allocation. Hepatic glycogen levels were assessed with 13C-MRS and insulin sensitivity was assessed using a hyperinsulinaemic-euglycaemic two-step clamp. Furthermore, glucose homeostasis was assessed with 24 h continuous glucose monitoring devices. Secondary outcomes included 24 h energy expenditure and substrate oxidation, hepatic lipid content and skeletal muscle mitochondrial capacity.
Results
Results are depicted as mean ± SEM. Hepatic glycogen content was similar between TRE and control condition (0.15±0.01 vs 0.15±0.01 AU, p=0.88). M value was not significantly affected by TRE (19.6±1.8 vs 17.7±1.8 μmol kg-1 min-1 in TRE vs control, respectively, p=0.10). Hepatic and peripheral insulin sensitivity also remained unaffected by TRE (p=0.67 and p=0.25, respectively). Yet, insulin-induced non-oxidative glucose disposal was increased with TRE (non-oxidative glucose disposal 4.3±1.1 vs 1.5±1.7 μmol kg-1 min-1, p=0.04). TRE increased the time spent in the normoglycaemic range (15.1±0.8 vs 12.2±1.1 h per day, p=0.01), and decreased fasting glucose (7.6±0.4 vs 8.6±0.4 mmol/l, p=0.03) and 24 h glucose levels (6.8±0.2 vs 7.6±0.3 mmol/l, p<0.01). Energy expenditure over 24 h was unaffected; nevertheless, TRE decreased 24 h glucose oxidation (260.2±7.6 vs 277.8±10.7 g/day, p=0.04). No adverse events were reported that were related to the interventions.
Conclusions/interpretation
We show that a 10 h TRE regimen is a feasible, safe and effective means to improve 24 h glucose homeostasis in free-living adults with type 2 diabetes. However, these changes were not accompanied by changes in insulin sensitivity or hepatic glycogen.
Trial registration
ClinicalTrials.gov NCT03992248 FUNDING: ZonMW, 459001013.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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