Observational Study
Copyright ©The Author(s) 2017.
World J Diabetes. Apr 15, 2017; 8(4): 154-164
Published online Apr 15, 2017. doi: 10.4239/wjd.v8.i4.154
Table 1 Cut-off points created to explore the impact of fasting on self-monitored blood glucose
SMBG value cut-offMorning fastedEvening postprandial
< 7.0 mmol/LNormal/goal levelNormal/goal level
7.0-9.05 mmol/LAbove goalNormal/goal level
9.05-11.1 mmol/LAbove goalAbove goal
> 11.1 mmol/LAbove goalAbove goal
Table 2 Baseline characteristics of participants
MeasurementMean ± SD
Anthropomorphic
Age (yr)53.8 ± 9.11
Weight100.6 ± 21.75 kg
BMI36.9 ± 8.29 kg/m2
Waist circumference (reference < 88 female, < 102 male)109.6 ± 11.1 cm
Daily hours fasted11.6 ± 1.9 h/d
Systolic BP (mmHg) T2DM goal < 130130.00 ± 17.80
Diastolic BP (mmHg) T2DM goal < 8080.50 ± 13.20
Biochemical
C-reactive protein (mg/L) (reference < 1.0 mg/L)4.31 ± 3.80
HOMA-IR calculated (normal < 2.5)6.91 ± 3.00
Fasting glucose (normal < 7.0 mmol/L)7.45 ± 1.52 mmol/L
Medications present during study period
Metformin10 (10)
Sulfonylureas1 (10)
Other diabetic medications1 (10)
Other non-diabetic medications8 (10)
Table 3 Differences between Study Phases for Biochemical and Anthropometric Parameters
MeasurementMean ± SD Phase 1Mean ± SD Phase 2Mean ± SD Phase 3Mean difference Phase 1 to 2Mean difference Phase 2 to 3Mean difference Phase 1 to 3
Clinical outcome
Weight (kg)100.6 ± 21.799.2 ± 21.399.5 ± 21.5-1.4 (P = 0.009)+0.28 (P = 1.0)-1.12 (P = 0.08)
BMI (kg/m2)36.9 ± 8.336.4 ± 8.136.5 ± 8.1-0.52 (P = 0.01)+0.1 (P = 1.0)-0.42 (P = 0.09)
Waist circumference (cm)109.6 ± 11.1107.8 ± 11.1107.5 ± 10.9-1.75 (P = 0.086)-0.30 (P = 1.0)-2.05 (P = 0.24)
Systolic BP (mmHg)130.0 ± 17.8127.0 ± 21.4128.5 ± 14.3-3 (P = 0.83)+1.5 (P = 1.0)-1.5 (P = 1.0)
Diastolic BP (mmHg)80.5 ± 13.279.8 ± 15.781.7 ± 12.2-0.72 (P = 1.0)+1.9 (P = 0.76)+1.2 (P = 1.0)
Daily hours fasted11.6 ± 1.916.8 ± 1.211.5 ± 2.0+5.2 (P < 0.005)-5.3 (P < 0.005)-0.09 (P = 1.0)
Biochemical outcome
C-reactive protein (mg/L)4.3 ± 3.84.0 ± 3.74.1 ± 3.5-0.3 (P = 0.9)+0.09 (P = 1.0)-0.25 (P = 1.0)
HOMA-IR6.9 ± 3.06.5 ± 2.46.6 ± 3.0-0.46 (P = 1.0)+0.11 (P = 1.0)-0.35 (P = 1.0)
Table 4 Morning, afternoon and postprandial self-monitored blood glucose levels decreased during intermittent fasting
14 d averaged SMBG pooledMean ± SD Phase 1Mean ± SD Phase 2Mean ± SD Phase 3% change from Phase 1 to 2% change from Phase 2 to 3
μfasting SMBG8.2 ± 1.37.7 ± 1.88.1 ± 1.4-6.10%+5.20%
μafternoon SMBG7.5 ± 1.07.2 ± 1.27.0 ± 0.9-4.00%-2.80%
μpost prandial SMBG8.7 ± 1.98.6 ± 1.98.8 ± 1.7-1.10%+2.30%
Table 5 Intermittent fasting improves fasting and postprandial glucose levels
Measured SMBG (mmol/L)BaselineInterventionFollow-up
Morning SMBG by phase
< 7.013.8%34.1%15.1%
7.0-9.0552.0%40.7%49.6%
9.05-11.133.3%18.0%32.8%
> 11.10.8%7.1%2.5%
Evening SMBG by phase
< 7.024.5%27.7%12.9%
7.0-9.0528.1%32.9%41.6%
9.05-11.127.4%19.7%28.7%
> 11.120.0%19.7%16.8%
Table 6 Ordinal Logistic Regression: Relationship between Hours Fasted Difference and morning, afternoon, and evening self-monitored blood glucose
SMBGOverall model
Odds ratioP value95%CI
Morning0.910.0040.85-0.97
Afternoon0.950.1810.88-1.02
Evening1.000.9000.94-1.07
Table 7 Patient reported diet composition and physical activity, by study phase
MeasureBaseline (mean ± SD)Intervention (mean ± SD)Follow-up (mean ± SD)
Extrapolated energy intake (kcal/d)1904.3 ± 404.11605.7 ± 375.51510.5 ± 755.41
Protein intake (g/d)94.2 ± 26.693.2 ± 26.179.4 ± 30.71
Carbohydrate intake (g/d)190.6 ± 58.5142.7 ± 62.1164.2 ± 93.91
Fat intake (g/d)86.9 ± 16.663.6 ± 25.260.9 ± 35.51
Physical activity (kcal/wk)4922.3 ± 3774.46778.56 ± 4329.54329.0 ± 3440.8