Periodic use of a fasting-mimicking diet in type 2 diabetes

In the Fasting In diabetes Treatment (FIT) trial, the department of Primary Care and Public Health of the Leiden University Medical Centre evaluated the feasibility and impact of periodic use of a fasting mimicking diet program as an adjunct to regular care on disease management in patients with type 2 diabetes mellitus. The project was conducted in collaboration with the Instituto Fondazione di Oncologia Molecolare and an American scale-up company, L-Nutra, which produces the fasting mimicking formula that was used in the trial.

Since more than 400 million people worldwide suffer from type 2 diabetes, and the burden of disease and health costs are expected to rise even further, exploration of novel options for treatment and/or prevention is a priority. Limited evidence suggests that intermittent energy restriction can improve metabolic health. Periodic fasting-

mimicking diets, designed to mimic the effect of total fasting while lessening its burden, have not been applied in T2D patients in primary care until now.

We randomised 100 people with type 2 diabetes, treated with metformin and/or diet alone, to use a fasting mimicking program for 5 consecutive days each month as an adjunct to regular care (intervention) or just regular care (control). If the intervention would reduce the need for glucose lowering medication and improve glycemic control, this would significantly contribute to ease the burden of diabetes and might help contain the rise of health care costs brought about by this globally rampant disease.

Our results indeed clearly show that integration of monthly cycles of FMD in regular care reduces the need for glucose lowering medication and substantially improves glycemic management in patients with T2D. The fact that all patients were routinely monitored and treated by their primary care physician adds to the clinical relevance of the findings.