Background
Time-restricted feeding is an emerging dietary intervention that is becoming increasingly popular. There are, however, no randomised clinical trials of time-restricted feeding in overweight patients with type 2 diabetes. Here, we explored the effects of time-restricted feeding on glycaemic regulation and weight changes in overweight patients with type 2 diabetes over 12 weeks.
Methods
Overweight adults with type 2 diabetes (n = 120) were randomised 1:1 to two diet groups: time-restricted feeding (n = 60) or control (n = 60). Sixty patients participated in a 10-h restricted feeding treatment program (ad libitum feeding from 8:00 to 18:00 h; fasting between 18:00 and 8:00 h) for 12 weeks.
Results
Haemoglobin A1c and body weight decreased in the time-restricted feeding group (− 1.54% ± 0.19 and − 2.98 ± 0.43 kg, respectively) relative to the control group over 12 weeks (p < 0.001). Homeostatic model assessment of β-cell function and insulin resistance changed in the time-restricted feeding group (0.73 ± 0.21, p = 0.005; − 0.51 ± 0.08, p = 0.02, respectively) compared with the control group. The medication effect score, SF-12 score, and the levels of triglycerides, total cholesterol and low-density lipoprotein cholesterol were improved in the time-restricted feeding group (− 0.66 ± 0.17, p = 0.006; 5.92 ± 1.38, p < 0.001; − 0.23 ± 0.08 mmol/L, p = 0.03; − 0.32 ± 0.07 mmol/L, p = 0.01; − 0.42 ± 0.13 mmol/L, p = 0.02, respectively) relative to the control group. High-density lipoprotein cholesterol was not significantly different between the two groups.
Conclusion
These results suggest that 10-h restricted feeding improves blood glucose and insulin sensitivity, results in weight loss, reduces the necessary dosage of hypoglycaemic drugs and enhances quality of life. It can also offer cardiovascular benefits by reducing atherosclerotic lipid levels.
Trial registration: This study was registered with the Chinese Clinical Trial Registry (ChiCTR-IPR-15006371).
Glucose-responsive polymer gels provide an attractive option for the design of a self-regulated insulin delivery system. Here, this paper reported the biocompatibility, glucose-sensitive behavior, and in vivo application of a dispersion of nanogels with three interpenetrating polymer networks of poly(Nisopropylacrylamide), dextran and poly(3-acrylamidophenylboronic acid) (P(NIPAM-Dex-PBA)). The nanogels had an average hydrodynamic radius of about 150 nm, and particle size increased with increasing content of dextran. The swelling behavior of the nanogels at different glucose concentrations revealed definite glucose sensitivity of P(NIPAM-Dex-PBA) particles. Furthermore, the analysis of relative cell proliferation suggested that the nanogels had good biocompatibility with L-929 mouse fibroblast cells. The loading amount of insulin, as a model drug, was up to 16.2%, and the drug release was dependent on the composition of dextran in the particles and the concentration of glucose present in release medium. In vivo experiments revealed that insulin-loaded nanogels decreased the blood glucose levels in diabetic rats and maintained 51% of the baseline level for almost 2 hours. The hypoglycemic effect of the drug-loaded nanogels was similar to that of free insulin after administration. Importantly, the drug-loaded nanogels could keep blood glucose levels stable and avoided blood sugar fluctuations compared with free insulin.
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