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Ensayo controlado aleatorizado2022Acceso abierto

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 · 99 citas

Cómo se estudió

Diseño
Ensayo controlado aleatorizado (indexado por PubMed)
Estudiado en
Personas
Resultado principal
Marcadores de salud y funcionamiento

Quién lo pagó

Financiación
Financiación independiente
Gobierno
ZonMw
Organización sin fines de lucro
Diabetes Fonds
Organización sin fines de lucro
European Association for the Study of Diabetes

Según 3 financiadores declarados y la declaración de financiación del texto completo.

Publicación

Publicado
2022-07-24 · Diabetologia · vol. 65 · número 10 · págs. 1710–1720
Editorial
Springer Science+Business Media
Citado
122 citas · más que el 99% de estudios similares · 12.2× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
32 trabajos
Acceso
Acceso abierto (revista híbrida) · CC-BY
Áreas de investigación
Dietary Effects on Health · Enhanced Recovery After Surgery · Circadian rhythm and melatonin
Palabras clave
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 autores

  • Charlotte Andriessen🇳🇱Maastricht University
  • Ciarán E. Fealy🇳🇱Maastricht University
  • Anna Veelen🇳🇱Maastricht University
  • Sten M. M. van Beek🇳🇱Maastricht University
  • Kay H. M. Roumans🇳🇱Maastricht University
  • Niels J. Connell🇳🇱Maastricht University
  • Julian Mevenkamp🇳🇱Maastricht University
  • Esther Moonen‐Kornips🇳🇱Maastricht University
  • Bas Havekes🇳🇱Maastricht University
  • Vera B. Schrauwen‐Hinderling🇳🇱Maastricht University
  • Joris Hoeks🇳🇱Maastricht University
  • Patrick Schrauwen🇳🇱 · autor de correspondenciaMaastricht University

Resumen

El texto original del estudio, en el idioma en que se publicó.

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.

Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial (CC BY).

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