Intermittent Fasting Aids Patients With Prediabetes or T2D

Intermittent fasting is a method for addressing excessive calorie intake by alternating between periods of eating and fasting. During the fasting period, which can last for 12-16 hours, all food is prohibited. This approach essentially requires the patient to skip at least one meal, and several variations of the approach are possible.

Intermittent fasting is less drastic than prolonged fasting for several days. The latter technique has supporters but also many detractors because of its questionable risk-benefit ratio and interference with basic human physiology. Intermittent fasting appears to be beneficial in certain metabolic disorders such as prediabetes and type 2 diabetes.

The results of a recent meta-analysis support this conclusion. The researchers used data from PubMed, Web of Science, and Scopus that were published before March 2024. Only randomized parallel-group or crossover trials were included, and each subject served as his or her own control. Intermittent fasting was compared with other methods of controlling food intake, such as a calibrated diet or a hypocaloric diet. Effectiveness criteria included body composition and parameters correlated with cardiometabolic health. A random effects meta-analysis was applied to summarized data to calculate weighted mean differences (WMDs) between groups, along with their 95% CI.

The researchers based the meta-analysis on 14 methodologically acceptable studies that included 1101 adult patients with prediabetes or confirmed type 2 diabetes.

Intermittent fasting was associated with a range of beneficial effects. Compared with a controlled but nonhypocaloric diet, intermittent fasting was associated with a significant decrease in body weight (WMD, −4.56 kg; 95% CI, −6.23 to −2.83; P = .001), body mass index (BMI; WMD, −1.99 kg/m²; 95% CI, −2.74 to −1.23; P = .001), A1c levels (WMD, −0.81%; 95% CI, −1.24 to −0.38; P = .001), and fasting blood glucose levels (WMD, −0.36 mmol/L; 95% CI, −0.63 to −0.09; P = .008).

The lipid profile also improved somewhat with intermittent fasting. The researchers observed changes in total cholesterol (WMD, −0.31 mmol/L; 95% CI, −0.60 to −0.02; P = .03) and triglycerides (WMD, −0.14 mmol/L; 95% CI, −0.27 to −0.01; P = .02). However, no significant effects were observed on fat or lean mass, visceral fat, blood pressure, insulin levels, or plasma low-density lipoprotein cholesterol levels.

Compared with a truly hypocaloric diet, weight loss was lower but still significant (WMD, −1.14 kg; 95% CI, −1.69 to −0.60; P = .001), as was BMI (WMD, −0.43 kg/m²; 95% CI, −0.58 to −0.27; P = .001).

According to the results of this meta-analysis with a small sample size, intermittent fasting could be beneficial for patients with prediabetes or type 2 diabetes. Significant weight loss and improved glycemic control could be achieved with this method, which needs to be maintained in the long term for the potential benefits to remain after harmful eating habits return.

This story was translated from JIM, which is part of the Medscape professional network, using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.