Evaluate the feasibility of monthly 5-day fasting-mimicking diet (FMD) cycles for people with type 2 diabetes (T2D) in primary care.
Approach:
Design: One hundred participants were randomly assigned to monthly FMD cycles plus usual care (n=51) or usual care alone (n=49) for 1 year.
Participants: Participants were receiving metformin or no glucose-lowering medication.
Evaluation: A mixed-methods assessment examined program completion, reasons for discontinuation, serum ketones, treatment satisfaction, and focus-group feedback from 20 participants.
Key Findings:
Among participants assigned to FMD, 61% completed the 1-year program; 31% discontinued because of diet-related issues and 8% for other reasons.
Serum ketone levels were higher in the FMD group than in the usual-care group; treatment satisfaction did not differ between groups.
Reported adherence facilitators included convenience, short cycles, not feeling hungry, motivation, belief in benefits, perceived health improvements, and social support.
Reported barriers included the diet’s taste, quantity, and frequency, as well as environmental temptations and lack of social support.
Interpretation:
The study assessed feasibility, not long-term clinical effectiveness. The authors noted that addressing identified facilitators and barriers might enhance adherence.
Limitations:
The sample was relatively small.
Participants were limited to those taking metformin or no glucose-lowering medication, limiting applicability to people receiving other therapies.
The qualitative findings came from 20 participants, and 39% of the FMD group discontinued the program.
These 10 states have paid family or medical leave programs and health, wellness, peer support, or monitoring resources available to physicians or other health professionals.
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