PMID- 28465792
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1948-9358 (Print)
IS  - 1948-9358 (Electronic)
IS  - 1948-9358 (Linking)
VI  - 8
IP  - 4
DP  - 2017 Apr 15
TI  - Effects of intermittent fasting on health markers in those with type 2 diabetes: 
      A pilot study.
PG  - 154-164
LID - 10.4239/wjd.v8.i4.154 [doi]
AB  - AIM: To determine the short-term biochemical effects and clinical tolerability of 
      intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM). 
      METHODS: We describe a three-phase observational study (baseline 2 wk, 
      intervention 2 wk, follow-up 2 wk) designed to determine the clinical, 
      biochemical, and tolerability of IF in community-dwelling volunteer adults with 
      T2DM. Biochemical, anthropometric, and physical activity measurements (using the 
      Yale Physical Activity Survey) were taken at the end of each phase. Participants 
      reported morning, afternoon and evening self-monitored blood glucose (SMBG) and 
      fasting duration on a daily basis throughout all study stages, in addition to 
      completing a remote food photography diary three times within each study phase. 
      Fasting blood samples were collected on the final days of each study phase. 
      RESULTS: At baseline, the ten participants had a confirmed diagnosis of T2DM and 
      were all taking metformin, and on average were obese [mean body mass index (BMI) 
      36.90 kg/m(2)]. We report here that a short-term period of IF in a small group of 
      individuals with T2DM led to significant group decreases in weight (-1.395 kg, P 
      = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although 
      not a study requirement, all participants preferentially chose eating hours 
      starting in the midafternoon. There was a significant increase (P < 0.001) in 
      daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h 
      fasting goal (mean 16.82 +/- 1.18). The increased fasting duration improved at-goal 
      (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic 
      Regression models revealed a positive relationship between the increase in hours 
      fasted and fasting glucose reaching target values (chi(2) likelihood ratio = 8.36, 
      P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial 
      SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 
      mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither 
      insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) 
      normalized during the IF phase. IF led to an overall spontaneous decrease in 
      caloric intake as measured by food photography (Remote Food Photography Method). 
      The data demonstrated discernable trends during IF for lower energy, 
      carbohydrate, and fat intake when compared to baseline. Physical activity, 
      collected by a standardized measurement tool (Yale Physical Activity Survey), 
      increased during the intervention phase and subsequently decreased in the 
      follow-up phase. IF was well tolerated in the majority of individuals with 6/10 
      participants stating they would continue with the IF regimen after the completion 
      of the study, in a full or modified capacity (i.e., every other day or reduced 
      fasting hours). CONCLUSION: The results from this pilot study indicate that 
      short-term daily IF may be a safe, tolerable, dietary intervention in T2DM 
      patients that may improve key outcomes including body weight, fasting glucose and 
      postprandial variability. These findings should be viewed as exploratory, and a 
      larger, longer study is necessary to corroborate these findings.
FAU - Arnason, Terra G
AU  - Arnason TG
AD  - Terra G Arnason, Department of Medicine, College of Medicine, University of 
      Saskatchewan, Saskatoon, SK S7K 5E5, Canada.
FAU - Bowen, Matthew W
AU  - Bowen MW
AD  - Terra G Arnason, Department of Medicine, College of Medicine, University of 
      Saskatchewan, Saskatoon, SK S7K 5E5, Canada.
FAU - Mansell, Kerry D
AU  - Mansell KD
AD  - Terra G Arnason, Department of Medicine, College of Medicine, University of 
      Saskatchewan, Saskatoon, SK S7K 5E5, Canada.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Diabetes
JT  - World journal of diabetes
JID - 101547524
PMC - PMC5394735
OTO - NOTNLM
OT  - Homeostasis model of assessment for insulin resistence index
OT  - Intermittent fasting
OT  - Remote food photography
OT  - Self-monitored blood glucose
OT  - Type 2 diabetes
COIS- Conflict-of-interest statement: There are no conflicts of interest to report.
EDAT- 2017/05/04 06:00
MHDA- 2017/05/04 06:01
PMCR- 2017/04/15
CRDT- 2017/05/04 06:00
PHST- 2016/11/25 00:00 [received]
PHST- 2017/02/11 00:00 [revised]
PHST- 2017/02/28 00:00 [accepted]
PHST- 2017/05/04 06:00 [entrez]
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2017/05/04 06:01 [medline]
PHST- 2017/04/15 00:00 [pmc-release]
AID - 10.4239/wjd.v8.i4.154 [doi]
PST - ppublish
SO  - World J Diabetes. 2017 Apr 15;8(4):154-164. doi: 10.4239/wjd.v8.i4.154.