Clinical Scorecard: Monthly fasting cycles may be feasible in T2D

At a Glance

Key Highlights

• In a 1-year randomized study of 100 participants, 61% assigned to monthly FMD cycles completed the program.
• Among FMD participants, 31% discontinued because of diet-related issues and 8% for other reasons.
• Treatment satisfaction did not differ between the FMD and usual-care groups.
• Focus groups with 20 participants identified convenience, short cycles, not feeling hungry, internal motivation, belief in beneficial effects, perceived health improvements, and social support as adherence facilitators.
• Taste, quantity, and frequency of the diet, environmental temptations, and lack of social support were reported as adherence barriers.

Guideline-Based Recommendations

Diagnosis

Management

• The study evaluated monthly 5-day FMD cycles alongside usual care; it assessed feasibility, not long-term clinical effectiveness.
• Study authors stated that addressing identified facilitators and barriers might enhance adherence.

Monitoring & Follow-up

• The feasibility evaluation included program completion, reasons for discontinuation, serum ketone levels, and treatment satisfaction.

Risks

• Diet-related difficulties contributed to discontinuation; 39% of participants assigned to FMD did not complete the 1-year program.
• The findings may not apply to patients receiving glucose-lowering therapies other than metformin because those patients were not included.

Patient & Prescribing Data

100 participants with T2D were randomized: 51 to monthly 5-day FMD cycles plus usual care and 49 to usual care alone. Eligible participants were receiving metformin or no glucose-lowering medication.

The FMD program lasted 1 year. In the FMD group, 61% completed it; 31% discontinued because of diet-related issues and 8% for other reasons. Treatment satisfaction did not differ between groups.

Clinical Best Practices

• Consider the study's limited sample size and restricted treatment population when interpreting its findings.
• Account for reported dietary barriers, including taste, quantity, frequency, environmental temptations, and limited social support.
• Recognize that the study assessed feasibility and did not establish long-term clinical effectiveness.

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