# Effects of Intermittent Fasting on Glycemic Control in Patients with Diabetes

> **NIH NIH P20** · UNIVERSITY OF KANSAS MEDICAL CENTER · 2024 · $254,508

## Abstract

Intermittent fasting (IF) is an alternative to daily calorie restriction for producing clinically relevant weight loss. 
Though intermittent fasting does not increase weight loss relative to daily calorie restriction, modifying the 
timing of food intake via intermittent energy restriction (IER) or time-restricted eating (TRE), two forms of 
intermittent fasting, may provide a pronounced benefit to glycemic control. However, these two IF approaches 
have not been thoroughly tested or compared in patients with type 2 diabetes (T2D). Further, pancreatic beta 
cell responsiveness and insulin action in response to a mixed meal depend on a functionally normal incretin 
axis. Two insulinotropic peptides, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like 
peptide-1 (GLP-1) are essential for postprandial glucose control. Incretin-stimulated insulin action contributes 
more than 70% of the insulin response to a meal in healthy adults, overshadowing the effect of glucose alone 
to stimulate insulin secretion. In patients with type 2 diabetes, the incretin response is blunted, contributing to 
poorer glycemic control. Similarly, higher levels of inflammation blunt insulin sensitivity. Intermittent fasting 
reduces inflammation and improves incretin expression in mice, however these effects have yet to be 
replicated in patients with T2D. Our goal is to evaluate potential mechanisms of benefit for two IF approaches 
on glycemic control in patients with T2D. The primary aim is to determine the effects of two forms of 
intermittent fasting on insulin action and whole-body insulin sensitivity. We will also compare changes in body 
composition between IER and TRE and conduct the first trial to determine the effects of both intermittent 
fasting approaches on the incretin response to a meal. In exploratory analyses, we will phenotype individuals 
based on metabolic assessments to determine potential predictors of response from each intervention. We will 
do this by leveraging and supplementing an existing randomized controlled trial utilizing both IF approaches 
within a 6-month multicomponent lifestyle change program incorporating a comprehensive health education 
program for diabetes via biweekly group meetings delivered remotely. Primary endpoints will be collected at 
weeks 0, 12, and 26, and 52 weeks. In addition to data already being collected on weight change, glycemic 
control via HbA1c and continuous glucose monitoring, we will conduct a 3-hour, 9-point mixed meal tolerance 
test (MMTT) with glucose, insulin, and c-peptide to allow for estimates of insulin secretion and pancreatic beta 
cell function. Additionally, we will assess the effects of IER and TRE on body composition, incretin response 
and inflammatory cytokine levels during the 12-month intervention. Mixed models with repeated measures 
analysis will be used to assess the effect of each approach on outcome measures and, secondarily, to 
compare these two forms of IF. The lon...

## Key facts

- **NIH application ID:** 10862683
- **Project number:** 5P20GM144269-03
- **Recipient organization:** UNIVERSITY OF KANSAS MEDICAL CENTER
- **Principal Investigator:** Felicia Steger
- **Activity code:** P20 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $254,508
- **Award type:** 5
- **Project period:** 2022-04-01 → 2027-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10862683

## Citation

> US National Institutes of Health, RePORTER application 10862683, Effects of Intermittent Fasting on Glycemic Control in Patients with Diabetes (5P20GM144269-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10862683. Licensed CC0.

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