Efficacy and safety of intermittent fasting for type 2 diabetes mellitus: A systematic review and meta-analysis of randomized trials

IF 1 Q4 ENDOCRINOLOGY & METABOLISM

Diabetes epidemiology and management Pub Date : 2025-01-01 DOI:10.1016/j.deman.2024.100249

Joshua Chadwick, Lavanya Ayyasamy, Madhanraj Kalyanasundaram, Ganeshkumar Parasuraman, Bhavani Shankara Bagepally, Jeyashree Kathiresan, Lokesh Shanmugam

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Abstract

Background & objectives

Type 2 diabetes mellitus (T2DM) is a pressing public health concern, contributing to 11 % of annual deaths and incurring direct expenses of $760 billion. Studies show intermittent fasting (IF) can effectively lower glycated haemoglobin (HbA1c) levels and reduce weight and levels in individuals with type 2 diabetes. The study's objective is to evaluate the efficacy and safety of IF on glycaemic control among patients with T2DM.

Methods

We conducted searches in the MEDLINE (Ovid), Embase, and SINOMED databases until February 29, 2024, focusing on glycaemic control as the outcome of interest. Secondary outcomes included changes in weight, and BMI (PROSPERO ID: CRD42022357598). We used a random effect model to synthesize the effect measure. We performed a sensitivity analysis to assess the robustness of the result.

Results

Out of the 24 studies identified, nine were deemed suitable for inclusion. Four studies, including 238 participants, were selected for the meta-analysis. The analysis revealed that IF and regular diets showed similar effects on glycemic control, HbA1c (−1.27 %, 95 % confidence interval [CI] −3.71 to 1.17) and fasting plasma glucose (−1.66, 95 % CI −4.22 to 0.90). Weight reduction outcomes were also similar between the two diets (−0.26, 95 % CI −1.43 to 0.91 kg). The frequency of hypoglycemic episodes was comparable across both groups.

Interpretation & conclusions

On the basis of moderate to low certainty of evidence, IF can be a safe dietary approach for patients with T2DM, with similar safety and effectiveness profiles to regular diets. However, larger-scale studies are recommended to confirm these findings.

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间歇性禁食治疗2型糖尿病的疗效和安全性：随机试验的系统回顾和荟萃分析

背景,目的2型糖尿病（T2DM）是一个紧迫的公共卫生问题，每年造成11%的死亡，直接费用达7600亿美元。研究表明，间歇性禁食（IF）可以有效降低2型糖尿病患者的糖化血红蛋白（HbA1c）水平，减轻体重和水平。该研究的目的是评估IF对T2DM患者血糖控制的有效性和安全性。方法我们在MEDLINE （Ovid）、Embase和SINOMED数据库中进行检索，检索截止至2024年2月29日，重点关注血糖控制作为感兴趣的结果。次要结局包括体重和BMI的变化（PROSPERO ID: CRD42022357598）。我们采用随机效应模型来综合效应测度。我们进行了敏感性分析以评估结果的稳健性。结果在确定的24项研究中，有9项被认为适合纳入。四项研究，包括238名参与者，被选中进行meta分析。分析显示，IF和常规饮食对血糖控制、糖化血红蛋白（- 1.27%，95%可信区间[CI] - 3.71至1.17）和空腹血糖（- 1.66,95%可信区间[CI] - 4.22至0.90）的影响相似。两种饮食的减肥结果也相似（- 0.26,95% CI - 1.43至0.91 kg）。两组的低血糖发作频率具有可比性。解释,结论在中等至低证据确定性的基础上，IF可作为T2DM患者的一种安全的饮食方法，其安全性和有效性与常规饮食相似。然而，建议进行更大规模的研究来证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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