Intermittent very-low calorie diet helps with glycaemic control

Intermittent very-low calorie diet (VLCD) appears to be effective in reaching optimal glycaemic control in obese type 2 diabetes patients, regardless of timing, a recent study has found.

Researchers conducted a randomized controlled trial, including 40 participants who were assigned 1:1:1 to 2 days/week (n=14) or 4 days/week (n=14) of VLCD or to a normal-diet control (n=12). The trial lasted for 18 weeks after a 2-week run-in period. The primary outcomes were changes in glycaemic control and the rate of diabetes remission.

At week 20, fasting plasma glucose (FPG) was significantly reduced in the 4-days/week (–39.7±12.5 mg/dL; p=0.003) group relative to baseline. Participants in the 2-days/week group likewise saw a nearly significant decrease (–25.1±12.5 mg/dL; p=0.051), while those in the control group experienced no change (–7.9±13.5 mg/dL; p=0.56).

Notably, the mean difference in the change in FPG between the 4- and 2-days/week groups was not significant (p=0.439).

Similar effects were reported for glycated haemoglobin (HbA1c), which dropped by 1.2±0.3 percent in the 4-days/week group (p<0.001) and by 0.7±0.3 percent in the 2-days/week group (p=0.042) relative to baseline. Change in the control group was not significant (p=0.862).

At the end of the trial, diabetes remission without the need for glucose-lowering drugs was achieved by 29 percent of participants in both the 4- and 2-days/week groups. None of the control patients achieved this endpoint.

“To our knowledge, this is the first randomized controlled trial comparing 2 days/week of intermittent VLCD with 4 days/week and the control group in patients with obesity and type 2 diabetes,” the researchers said. “Our current study demonstrated that either 2 days/week or 4 days/week of intermittent caloric restriction was relatively comparable and highly effective in improving glycaemic control.”