Abstract

Introduction: Time-restricted eating (TRE) is a type of intermittent fasting reducing the daily time window for eating and drinking, usually without other dietary restrictions. TRE has been shown to improve body weight and glycemic control, but evidence in people with type 2 diabetes (T2D) is lacking. The objective of this pilot study was to investigate the feasibility of a 12-week TRE intervention targeting people with T2D to inform the design of a 1-year RCT.
Methods: In this single-arm pilot study, 10 men and 10 women with T2D (mean (SD) HbA1c: 62 (9) mmol/mol and T2D duration: 15 (6) years) followed a 12-week TRE intervention. The design was informed by a preceding needs assessment study including people with T2D, relatives, and health care professionals (HCPs). The participants initially followed 8 weeks of strict TRE with a self-selected 10-hour eating window to obtain lived experiences with TRE, followed by a 4-week TRE period with individual adjustments and support options. The timing of the eating window was planned during conversations with an HCP at visit 1 (baseline). Through conversations at visit 2 (8 weeks), participants’ potential challenges and needs were discussed with an HCP. Individual adjustment and support options were planned for the final 4-week period, and included: occasional rescheduling of the eating window, calorie-free beverages outside the eating window, and support from peers, relatives, and HCPs. Participants received a weekly e-mail with a link to a simple questionnaire to fill in the preceding day’s eating window. Body weight and HbA1c were measured at baseline and after 12 weeks. Qualitative interviews were conducted at visit 3 (12 weeks). A deductive content analysis based on conversations (visit 2) and interviews (visit 3) was performed focusing on how adjustment and support options were received and experienced by the participants and how they assisted the maintenance of TRE during the intervention.
Results: Nineteen participants completed the intervention. The median (Q1, Q3) eating window was 10.0 hours (9.8, 10.0) throughout the 12 weeks. Median adherence to the eating window across all 12 weeks was 94%, ranging from 0% to 99%. 17 participants reported to have followed TRE on at least 6 out 7 days. After 12 weeks, mean (95%CI) reductions in body weight of -2.0 kg (-2.9, -1.1) and HbA1c of -4.1 mmol/mol (-6.7, -1.4) were observed. During the last 4 weeks, all participants chose to implement one or more of the individualized adjustment and support options. Overall, adjustments and support eased TRE implementation in daily life by adding flexibility to the eating concept, enabled maintenance of a social life with friends and family, and eased challenging times with TRE. Participants did not report any severe adverse events.
Conclusion: We demonstrated that 12 weeks of TRE was feasible in terms of easy recruitment and high retention and adherence. Moreover, TRE may improve glycemic control and reduce body weight in people with T2D. It seems crucial to offer individualized support and adjustments to improve implementation and sustainability of the TRE concept.
Original languageDanish
Publication dateMay 2024
Publication statusPublished - May 2024
EventEuropean Congress on Obesity - Venedig, Italy
Duration: 12 May 202415 May 2024

Conference

ConferenceEuropean Congress on Obesity
Country/TerritoryItaly
CityVenedig
Period12/05/202415/05/2024

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