Fasting and the late complications of diabetes mellitus: a prospective randomized controlled study in patients with diabetes mellitus type 2

Background & Aim:

Fasting has been shown to cause beneficial effects on lifespan, stress-resistance and against oxidative damage. To minimize the burden of fasting, a “fasting-mimicking-diet” (FMD) was developed. FMD mimics metabolically fasting effects in the organism through a low calorie, low protein, low carbohydrate and high in unsaturated fats dietary composition. The aim of this study is to investigate the late complications of diabetes during periodic FMD intake in patients with diabetes mellitus type 2 and diabetic nephropathy.

Methods:

This is a prospective randomized controlled monocentric intervention study. Patients with diabetes mellitus type 2 and elevated albuminuria are randomized in two groups: an intervention group where patients receive periodically for 5 consecutive days once a month FMD, and a control group where patients receive Mediterranean diet. Both groups undergo regular examinations regarding the late complications of diabetes. Change of albuminuria is analyzed as primary endpoint.

Results & Conclusions:

After three cycles of dietary intervention the change of albuminuria compared to baseline shows a decrease in the intervention group. Moreover we observe an improvement in several metabolic parameters in the intervention group resulting in a decrease of the antidiabetic and/or antihypertensive medication. The change in albuminuria in the intervention group correlates positively with the change of MG-H1, a dicarbonyl-derived advanced glycation end-product. This is the first randomized controlled study that investigates the effect of fasting on the diabetic late complications. Fasting and FMD could trigger biochemical changes in diabetes context and better understanding of the underlying mechanisms can be used for future therapeutic approaches.