Kramer Caroline Kaercher, Zinman Bernard, Feig Denice S, Retnakaran Ravi
Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada.
Division of Endocrinology, University of Toronto, Toronto, ON M5T 3L9, Canada.
J Clin Endocrinol Metab. 2025 May 19;110(6):e2045-e2053. doi: 10.1210/clinem/dgae594.
Time-restricted eating (TRE), which consists of restricting the eating window to typically 4 to 8 hours (while fasting for the remaining hours of the day), has been proposed as a nonpharmacological strategy with cardiometabolic benefits but little is known about its metabolic effect on type 2 diabetes mellitus (T2DM).
We evaluated whether TRE can improve pancreatic β-cell function and metabolic status in overweight individuals with early T2DM.
In a randomized, crossover trial, 39 participants (mean 2.9 years of diabetes duration, baseline glycated hemoglobin A1c [HbA1c] 6.6% ± 0.7% and body mass index [BMI] 32.4 ± 5.7) were randomly assigned to either an initial intervention consisting of 6 weeks of TRE (20 h-fasting/4 h-eating) or standard lifestyle. The primary outcome of β-cell function was assessed by the Insulin Secretion-Sensitivity Index-2 (ISSI-2) derived from an oral glucose tolerance test.
As compared to standard lifestyle, TRE induced a 14% increase in ISSI-2 (+14.0 ± 39.2%; P = .03) accompanied by a 14% reduction of hepatic insulin resistance as evaluated by HOMA-IR (-11.6% [-49.3 to 21.9]; P = .03). Fasting glucose did not differ between interventions, but TRE yielded a statistically significant reduction in HbA1c (-0.32 ± 0.48%; P < .001). These metabolic improvements were coupled with a reduction of body weight of 3.86% (-3.86 ± 3.1%; P < .001) and waist circumference of 3.8 cm (-3.8 ± 7.5 cm; P = .003).
TRE improved β-cell function and insulin resistance in overweight patients with early diabetes, accompanied by beneficial effects on adiposity.
限时进食（TRE），即把进食窗口限制在通常4至8小时（同时在一天中的其余时间禁食），已被提议作为一种具有心脏代谢益处的非药物策略，但对其对2型糖尿病（T2DM）的代谢影响知之甚少。
我们评估了限时进食是否能改善超重的早期2型糖尿病患者的胰腺β细胞功能和代谢状况。
在一项随机交叉试验中，39名参与者（糖尿病病程平均2.9年，基线糖化血红蛋白A1c [HbA1c] 6.6% ± 0.7%，体重指数[BMI] 32.4 ± 5.7）被随机分配至初始干预组，该组进行为期6周的限时进食（禁食20小时/进食4小时）或标准生活方式干预。通过口服葡萄糖耐量试验得出的胰岛素分泌-敏感性指数-2（ISSI-2）评估β细胞功能的主要结果。
与标准生活方式相比，限时进食使ISSI-2增加了14%（+14.0 ± 39.2%；P = 0.03），同时通过HOMA-IR评估的肝脏胰岛素抵抗降低了14%（-11.6% [-49.3至21.9]；P = 0.03）。干预组之间空腹血糖无差异，但限时进食使HbA1c有统计学意义的降低（-0.32 ± 0.48%；P < 0.001）。这些代谢改善伴随着体重减轻3.86%（-3.86 ± 3.1%；P < 0.001）和腰围减少3.8厘米（-3.8 ± 7.5厘米；P = 0.003）。
限时进食改善了超重的早期糖尿病患者的β细胞功能和胰岛素抵抗，并对肥胖产生有益影响。
