Zeng Xin, Ji Qi-Pei, Jiang Zong-Zhe, Xu Yong
Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Diabetol Metab Syndr. 2024 Oct 28;16(1):254. doi: 10.1186/s13098-024-01492-9.
Type 2 diabetes mellitus (T2DM) is a globally prevalent chronic condition. Individuals with T2DM are at increased risk of developing complications associated with both macrovascular and microvascular pathologies. These comorbidities reduce patient quality of life and increase mortality. Dietary restriction is a principal therapeutic approach for managing T2DM. This study assessed the effects of various dietary regimens on body weight and metabolic profiles in T2DM patients, aiming to determine the most beneficial interventions for enhancing clinical outcomes and overall well-being.
We conducted a literature search in PubMed, Embase, and Web of Science from 2003 to April 15, 2024. The risk of bias was assessed via the Revised Cochrane risk-of-bias tool for randomized trials (RoB2). The certainty of the evidence was appraised via the confidence in network meta-analysis (CINeMA) framework. Intermittent fasting (IF) was directly compared with continuous energy restriction (CER) via Review Manager 5.4. Network meta-analysis was statistically assessed via R Studio 4.3.3 and STATA 14.0.
Eighteen studies involving 1,658 participants were included. The network meta-analysis indicated that intermittent energy restriction, the twice-per-week fasting, time-restricted eating, fasting-mimicking diets (FMD), and CER interventions were more effective than conventional diets. Direct comparisons revealed that IF was as effective as CER for reducing glycated haemoglobin A1c, body weight, and body mass index. The results of the cumulative ranking analysis demonstrated that FMD had the greatest combined intervention effect, followed by TRE in terms of overall effectiveness.
Both IF and CER exert positive influences on weight control and metabolic profile enhancement in individuals with T2DM, with FMD as part of IF demonstrating the greatest impact. To substantiate these findings, more rigorous randomized controlled trials that directly compare the effects of the different IF regimens with one another and with the CER regimen are needed.
2型糖尿病（T2DM）是一种全球普遍存在的慢性疾病。T2DM患者发生与大血管和微血管病变相关并发症的风险增加。这些合并症会降低患者的生活质量并增加死亡率。饮食限制是管理T2DM的主要治疗方法。本研究评估了各种饮食方案对T2DM患者体重和代谢谱的影响，旨在确定对改善临床结局和整体健康最有益的干预措施。
我们在2003年至2024年4月15日期间在PubMed、Embase和Web of Science上进行了文献检索。通过修订的Cochrane随机试验偏倚风险工具（RoB2）评估偏倚风险。通过网络Meta分析置信度（CINeMA）框架评估证据的确定性。通过Review Manager 5.4将间歇性禁食（IF）与持续能量限制（CER）直接进行比较。通过R Studio 4.3.3和STATA 14.0对网络Meta分析进行统计学评估。
纳入了18项研究，共1658名参与者。网络Meta分析表明，间歇性能量限制、每周两次禁食、限时进食、模拟禁食饮食（FMD）和CER干预措施比传统饮食更有效。直接比较显示，IF在降低糖化血红蛋白A1c、体重和体重指数方面与CER一样有效。累积排名分析结果表明，FMD的综合干预效果最大，就总体有效性而言，其次是限时进食。
IF和CER对T2DM患者的体重控制和代谢谱改善均有积极影响，FMD作为IF的一部分显示出最大影响。为证实这些发现，需要进行更严格的随机对照试验，直接比较不同IF方案彼此之间以及与CER方案的效果。
