All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Interval fasting is superior to traditional medications in the management of early type 2 diabetes
Last reviewed: 02.07.2025
A study has found that intermittent fasting and meal replacement diets can improve glucose control in patients with early-stage type 2 diabetes.
The study was published in the journal JAMA Network Open.
Type 2 diabetes is a significant public health problem worldwide. According to the International Diabetes Federation's 2021 data, about 537 million adults have type 2 diabetes. China has the highest prevalence of diabetes in the world, with a 56.6% increase in adult diabetics from 2011 to 2021. The current prevalence of diabetes in China is 12.4%, and about 50% of the population is overweight or obese.
This study was conducted to evaluate the efficacy of intermittent fasting with meal replacement (5:2 diet) in glucose control and weight loss in Chinese adults with early-stage type 2 diabetes.
The randomized clinical trial included 405 Chinese adults with newly diagnosed type 2 diabetes who had not taken antidiabetic or weight-loss medications in the past three months. Participants were randomly assigned to receive either metformin, empagliflozin, or a 5:2 meal replacement diet for 16 weeks.
In the 5:2 diet group, participants replaced their usual three meals with low-energy foods on two non-consecutive days per week. On the other five days, they could eat breakfast and lunch of their choice, but consumed the meal replacement for dinner.
The 5:2 diet group had the most significant reduction in glycated hemoglobin (HbA1c) compared to the metformin and empagliflozin groups. Additionally, this group showed a significant reduction in fasting glucose by 30.3 mg/dL, as well as reductions in body weight, waist and hip circumference, systolic and diastolic blood pressure.
In the 5:2 diet group, one patient experienced constipation and eight experienced hypoglycemia. In the metformin group, 26 patients experienced mild gastrointestinal symptoms and eight experienced hypoglycemia. In the empagliflozin group, three patients experienced urinary symptoms, five experienced hypoglycemia, and one patient experienced thirst. There were also serious adverse events in this group in two patients, including severe rash and hospitalization due to elevated blood ketones, which resolved with treatment.
The study shows that the 5:2 meal replacement diet strategy can effectively improve glucose control and reduce body weight in patients with early type 2 diabetes. These results highlight that this approach may be more effective in managing diabetes and obesity compared with two antidiabetic drugs, metformin and empagliflozin.
Future studies are needed to evaluate the long-term effectiveness of the 5:2 diet in patients taking antidiabetic medications and having higher baseline glycated hemoglobin levels. Overall, the study results suggest that the 5:2 diet strategy may be an effective initial intervention for the early management of type 2 diabetes.