What does this research mean for the field?

Intermittent energy restriction and time-restricted eating produce similar rates of type 2 diabetes remission and substantial reductions in diabetes medication burden over 12 months. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study evaluates the effects of intermittent fasting methods on diabetes remission and medication needs in type 2 diabetes.

June 7, 2026

2762-LB: Type 2 Diabetes Remission Rate and Change in Medication Burden after 12 Months of Intermittent Fasting

Key Points

This study evaluates the effects of intermittent fasting methods on diabetes remission and medication needs in type 2 diabetes.
Randomized 1:1 assignment to intermittent energy restriction (IER) or time-restricted eating (TRE).
Fifty-seven adults with type 2 diabetes underwent an intervention lasting 12 months.
Outcomes measured included diabetes remission and changes in medication burden through multiple follow-up points.
Twelve months showed 14% remission rates overall, with 17% in IER and 11% in TRE groups (p=0.48).
67% of participants de-intensified diabetes therapy by 12 months (IER 67%, TRE 68%; p=0.93).
Both fasting methods resulted in substantial reductions in overall medication burden.

Abstract

Introduction and Objective: Intermittent energy restriction (IER) and time-restricted eating (TRE) are two forms of intermittent fasting that may reduce diabetes medication needs in type 2 diabetes (T2D). However, head-to-head comparisons of IF approaches and trials using IF in T2D remain limited. We evaluated diabetes remission and pharmacologic de-intensification in a secondary analysis of a 12-month parallel intervention trial. Methods: Fifty-seven adults with T2D with overweight/obesity who were weight stable and stable on diabetes and weight-loss medications for ≥3 months were randomized 1:1 to IER (550-800 kcal/d on 2-3 d/week) or TRE (≤8-hr eating window). Both groups received diabetes education and dietitian support for 6 months, followed by 6 months of low-contact follow-up. Medication changes were guided by HbA1c, continuous glucose monitoring, and weight change. Outcomes were collected at 0, 3, 6 and 12 months, and included T2D remission (HbA1c 6.5% for ≥3 months without glucose-lowering therapy) and medication type, count, and intensity. Group differences were assessed using chi-square tests. Results: Baseline diabetes medication count was similar between IER (1.6 ± 0.7) and TRE (2.1 ± 1.3), and 12% used insulin (IER 2/29 7%, TRE 5/28 18%; p=0.39. Among those on diabetes pharmacotherapy at baseline, 67% de-intensified therapy by 12 months (IER 18/27 67%, TRE 19/28 68%; p=0.93), and 24% discontinued all diabetes medications (IER 6/27 22%, TRE 7/28 25%; p=0.81). Eleven participants (19%) achieved remission by 6 months (IER 4/29 14%, TRE 7/28 25%; p=0.28), though some regressed between 6 and 12 months. At 12 months, 14% met T2D remission criteria (IER 5/29 17%, TRE 3/28 11%; p=0.48). Conclusion: Both IER and TRE led to substantial reductions in diabetes medication burden and produced similar T2D remission rates. These findings support either intermittent fasting approach as a potential strategy to reduce dependence on pharmacotherapy in T2D, though follow-up is needed to determine durability. Disclosure F. Steger: None. J.M. Miles: None. J. Thyfault: None. J. Donnelly: None. R. Montgomery: None. L. Clark: None. K. Grdinovac: None. Funding American Diabetes Association (7-22-JDFN-13), NIH NIGMS (P20GM144269; Sub-Project 8116), CTSA Award #UL1TR002366.

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