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Ensayo controlado aleatorizado2024Financiación no declaradaAcceso abierto

A 5:2 Intermittent Fasting Meal Replacement Diet and Glycemic Control for Adults With Diabetes: The EARLY Randomized Clinical Trial

Guo L, Xi Y, Jin W, Yuan H, Qin G, Chen S, Zhang L, Liu Y, Cheng X, Liu W, Yu D

JAMA network open · 43 citas

Etiquetas de revisión

Financiación no declarada

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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 no declarada

Publicación

Publicado
2024-06-21 · JAMA Netw Open · vol. 7 · número 6 · pág. e2416786
Editorial
American Medical Association
Citado
58 citas · más que el 99% de estudios similares · 13.0× el promedio de su campo
Impacto
Entre el 10 % más citado de su campo
Referencias
40 trabajos
Acceso
Acceso abierto (revista) · CC-BY
Áreas de investigación
Dietary Effects on Health · Diet and metabolism studies · Genetics, Aging, and Longevity in Model Organisms
Palabras clave
Medicine, Glycemic, Overweight, Body mass index, Type 2 diabetes, Diabetes mellitus, Metformin, Randomized controlled trial, Internal medicine, Clinical endpoint, Weight loss, Hemoglobin A, Intermittent fasting, Obesity, Physical therapy, Endocrinology
MeSH
humans, diabetes mellitus, type 2, metformin, benzhydryl compounds, glucosides, blood glucose, hypoglycemic agents, fasting, adult, middle aged, china, female, male, glycemic control, glycated hemoglobin, intermittent fasting

11 autores

  • Lixin Guo🇨🇳 · autor de correspondenciaChinese Academy of Medical Sciences & Peking Union Medical College
  • Yue Xi🇨🇳Jinzhou Medical University
  • Jin Wenbo🇨🇳Nanyang Institute of Technology
  • Huijuan Yuan🇨🇳Henan Provincial People's Hospital
  • Guijun Qin🇨🇳First Affiliated Hospital of Zhengzhou University
  • Shuchun Chen🇨🇳Hospital of Hebei Province
  • Lihui Zhang🇨🇳Hebei Medical University; Second Hospital of Hebei Medical University
  • Yu Liu🇨🇳Nanjing Medical University
  • Xingbo Cheng🇨🇳Soochow University; First Affiliated Hospital of Soochow University
  • Wen Liu🇨🇳Beijing Tongren Hospital; Capital Medical University
  • Dongni Yu🇨🇳Chinese Academy of Medical Sciences & Peking Union Medical College

Resumen

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

Importance

An intermittent fasting plan consisting of 2 nonconsecutive fasting days and 5 days of habitual intake per week and meal replacement diet (5:2 MR) could provide additional benefits to patients with type 2 diabetes.

Objective

To evaluate the effect of the 5:2 MR on glycemic control among patients with early type 2 diabetes compared with metformin and empagliflozin.

Design, setting, and participants

The EARLY (Exploration of Treatment of Newly Diagnosed Overweight/Obese Type 2 Diabetes Mellitus) study is a randomized, open-label, active parallel-controlled clinical trial conducted between November 13, 2020, and December 29, 2022, in 9 centers across China. A total of 509 eligible patients underwent screening, out of which 405 were randomly assigned to 3 groups and included in the intention-to-treat analysis.

Interventions

Patients were randomly allocated in a 1:1:1 ratio to receive either metformin, empagliflozin, or 5:2 MR. The treatment was 16 weeks, with an 8-week follow-up.

Main outcomes and measures

The primary end point was the change in hemoglobin A1c (HbA1c) level from baseline to 16 weeks. Secondary end points included changes in body weight, anthropometric measurements, and biochemical parameters.

Results

Of the 405 randomized participants (265 men [65.4%]; mean [SD] age, 45.5 [11.0] years; mean [SD] body mass index, 29.5 [4.1]; and mean [SD] HbA1c level, 7.9% [0.6%]), 332 completed the 16-week treatment. From baseline to week 16, participants in the 5:2 MR group showed the greatest reduction in HbA1c (least-squares mean [LSM], -1.9% [SE, 0.2%]), significantly greater than patients receiving metformin (LSM, -1.6% [SE, 0.2%]; adjusted LSM difference, -0.3% [95% CI, -0.4% to -0.1%]) and empagliflozin (LSM, -1.5% [SE, 0.2%]; adjusted LSM difference, -0.4% [95% CI, -0.6% to -0.2%]). At week 16, the mean weight loss in the 5:2 MR group (LSM, -9.7 kg [SE, 2.2 kg]) was greater than that in the metformin group (LSM, -5.5 kg [SE, 2.3 kg]) and empagliflozin group (LSM, -5.8 kg [SE, 2.3 kg]).

Conclusions and relevance

This randomized clinical trial of Chinese adults with overweight or obesity and with early type 2 diabetes found that 5:2 MR could improve glycemic outcomes and weight loss in the short term compared with metformin or empagliflozin, making it a promising initial intervention and early management for type 2 diabetes.

Trial registration

Chinese Clinical Trial Registry Identifier: ChiCTR2000040656.

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

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