Effect Of Time-restricted Feeding On Newly Diagnosed Overweight And Obese Patients With Type 2 Diabetes

Background:In recent years,with the improvement of people’s living standards,the incidence of diabetes has been increasing.Type 2 diabetes has become a common problem in society,which greatly increases the risk of cardiovascular and cerebrovascular diseases,inflammatory diseases and metabolic related diseases.According to the latest statistics,there are about 425 million cases of diabetes worldwide.At present,the latest diabetes guidelines recommend metformin as a first-line treatment,mainly for overweight and obese people with type 2 diabetes.Metformin can reduce glucose output in the liver by promoting glycogen breakdown and inhibiting glycogen production.It can also improve the ability of peripheral tissues to absorb and use glucose,which can reduce body mass index and improve insulin resistance.However,there are certain side effects in the application process of this drug,the most common intestinal discomfort such as nausea,diarrhea,indigestion,etc.It can even induce lactic acidosis.Now,most people with diabetes urgently to seek a kind of can be adjusted through the way of life to improve blood sugar.The method of current research shows that the method at home and abroad mainly for pre-diabetes,obesity,and the original oral glucose-lowering drugs(such as insulin and metformin,sulfonylureas,etc.)for the treatment of diabetic patients on the basis of population studies,it can regulate blood sugar,reducing blood lipid,weight reduction,but there is no single agency method is applied to the study of first diagnosis in patients with T2 DM.In this study,a new diet method was proposed for newly diagnosed overweight and obese type 2 diabetes patients.Compared with metformin,it has the advantages of higher safety,less side effects and higher cost performance,so as to provide an effective,non-drug treatment method for such people.Objective:By observing the clinical effect of time-restricted feeding therapy on newly diagnosed overweight and obese patients with type 2 diabetes,this paper provides a new treatment method for these patients.Methods:A total of 80 patients who met the inclusion criteria were selected from the Second Hospital of Jilin University between October 2018 and June 2019.They were randomly divided into the time-restricted feeding group(n = 40)and the metformin group(n = 40).Patients in both groups were given routine treatment,including diabetic diet and exercise guidance.The observation group was treated with time-limited feeding therapy,that is,the daily eating time of the group was limited to 8 hours,that is,the eating time was from 8:00 to 16:00,and the rest time was fasting,during which the intake of water was not restricted.The control group was given0.5g of oral metformin(Glucophage),1 tablet at breakfast and dinner.General data and changes in blood biochemical indexes before and after treatment were monitored and recorded in the two groups.Including body weight,waist circumference,BMI,fasting plasma glucose(FPG),blood sugar 2 hours after meal(2h PG),glycosylated hemoglobin(HBA1c),fasting insulin(FINS),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),insulin resistance index(HOME-IR),insulin sensitive index(HOME-IS),blood pressure(systolic and diastolic blood pressure),the incidence of hypoglycemia,incidence of adverse reactions.Results:1.A total of 80 patients meeting the inclusion criteria were collected.Results a total of 3 patients dropped out of the experiment for different reasons during the study.Finally,39 patients in the observation group and 38 patients in the control group were collected.Before treatment,there was no statistical significance in the comparative analysis of general information between the two groups(P > 0.05).2.FPG and 2h PG in both groups were lower than those before treatment at 4and 12 weeks,and the decrease was more obvious at 12 weeks,with statistical significance(P < 0.05).The level of Hb A1 c in the two groups at 4 weeks was not significantly different from that before treatment(P > 0.05).At the 12 th week,it was significantly lower than that before treatment(P < 0.05).There was no statistical significance between groups(P > 0.05).3.At each follow-up point,FINS and HOMA-IR decreased and HOMA-IS increased in both groups compared with baseline.The FINS and HOMA-IR of the time-restricted feeding group decreased significantly at 12 weeks(P < 0.05).HOMA-IR in metformin group was significantly decreased at 4 weeks compared with before treatment,and FINS,HOMA-IS and HOMA-IR were significantly changed at 12 weeks(P<0.05).There was no statistical significance between groups(P > 0.05).4.Body weight of both groups decreased from baseline at 4 and 12 weeks(P< 0.05),BMI and waist circumference also decreased at all follow-up points,and significantly decreased at 12 weeks(P < 0.05).There was no significant difference between the two groups(P < 0.05).5.The systolic blood pressure of the two groups decreased at 4 and 12 weeks compared with that before treatment(P < 0.05),and the decrease was more obvious in the time-restricted feeding group at 12 weeks compared with 4 weeks,with statistical significance(P < 0.05).Diastolic blood pressure in both groups did not decrease significantly at 4 weeks(P > 0.05),but decreased significantly from baseline at 12 weeks(P < 0.05).Compared with the metformin group,the systolic blood pressure in the time-restricted feeding group decreased significantly after 4and 12 weeks of treatment,with statistical significance(P < 0.05),while the diastolic blood pressure was not significant between the two groups(P > 0.05).6.After 4 and 12 weeks of treatment,the levels of TG,TC and LDL-C in the two groups decreased compared with before treatment.The levels of TG,TC and LDL-C in the time-restricted feeding group decreased significantly at 12 weeks compared with before and 4 weeks of treatment,with statistical significance(P <0.05).TG and TC in metformin group were significantly decreased at 12 weeks compared with before treatment(P < 0.05),and LDL-C were significantly decreased at 12 weeks,as well as before and after 4 weeks of treatment,with statistical significance(P < 0.05).There was no significant difference in HDL-C between the two groups(P > 0.05).There was no significant difference in TG,TC,HDL-C and LDL-C between the two groups(P > 0.05).7.No hypoglycemia occurred during the whole trial.During the whole follow-up,there was no obvious adverse reaction in the time-restricted feeding group.Two patients in the metformin group reported mild nausea and vomiting,which improved after 3-5 days without affecting the course of the trial.Conclusion:1.For newly diagnosed overweight and obese T2 DM patients,TRF can improve blood glucose levels,improve insulin sensitivity,reduce body weight,reduce blood lipid levels,improve abdominal obesity,lower body mass index,and lower blood pressure levels in these patients.2.TRF can provide a new treatment option for patients with T2 DM,helping to control blood glucose and prevent and treat complications.