Short Term Intermittent Fasting and Insulin Resistance (IFAST)
Effects of Short Term Intermittent Fasting on Insulin Resistance in Type 2 Diabetes
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Approximately 250.000 patients are diagnosed with type 2 diabetes (T2DM) in Denmark, and world-wide close to 350 million people suffer from diabetes. T2DM develops in genetically susceptible individuals as a result of excess energy intake and insufficient amount of daily physical activity. The pathophysiology encompasses a mismatch between the insulin secretory capacity and insulin sensitivity, predominantly manifested in skeletal muscle as insulin resistance. T2DM is associated with increased morbidity and mortality.
The disease is triggered by the individual lifestyle, and thereby the potential for prevention and reversal of the disease in its early years after diagnosis is quite large.
One potential way to improve glucose homeostasis is by intermittent fasting, also known as alternate day fasting. Intermittent fasting means switching between eating and fasting, and it is a variation of calorie restriction. Intermittent fasting has been studied in animals. Together with calorie restriction, intermittent fasting is the most efficient way to expand lifespan of many animal species without genetically altering them. A wide range of age related changes are delayed including beneficial effects on hypertension, degenerative brain disease, immune responses, DNA repair capacity and glucose homeostasis. Fat redistribution with fat translocating from between the organs and the liver to the subcutis.
Little is known about intermittent fasting in humans. In 2005 the investigators experimentally tested this concept in young healthy males and found that 15 days of alternating days with fast and food intake increased insulin sensitivity by 16% without any changes in body weight.
The explanation could be oscillations in cellular energy stores. Skeletal muscle contains approximately 80% of the stored glycogen alone by virtue of the muscle mass. The liver has a higher glycogen concentration, but it is much smaller. A single prolonged (>24 hrs) day of fasting may not decrease muscle glycogen, while the decrease in the liver is very fast. A muscle glycogen lowering effect of continued intermittent fasting would be expected, and experimentally indicated.
The intermittent fasting method may appeal to some patients, who do not exercise, and the need for testing this intervention in patients with type 2 diabetes is obvious.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Copenhagen, Denmark, 2200
- Xlab, Department of Biomedical Sciences, University of Copenhagen
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- BMI 28-35
- Type 2 diabetes or metabolically healthy
- Diet or orally administered treatment for type 2 diabetes
Exclusion Criteria:
- Regular physical activity
- Other diseases than type 2 diabetes
- insulin treatment
- alcohol abuse
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: SEQUENTIAL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
ACTIVE_COMPARATOR: Intermittent fasting
Intermittent fasting conducted by a group of subjects with type 2 diabetes mellitus and an age- and BMI matched control group.
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Alternate day fasting (ADF) (water permitted) for 3 weeks with double energy intake every other day.
Followed by ADF for 3 weeks with ad libitum diet on eating days.
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ACTIVE_COMPARATOR: Time control
A time control period.
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Time control period with no change in eating habits.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from Baseline in Insulin Sensitivity after 20 days of intermittent fasting.
Time Frame: 46 days
|
An euglycemic hyperinsulinemic clamp is performed at day 1 and repeated at day 23 after a control period with no change in the diet.
Baseline insulin sensitivity is determined based on these two measurements.
The euglycemic hyperinsulinemic clamp is repeated at day 46 after the intermittent fasting period (day 25-44) and two days (day 24 and 45) with a normal diet.
|
46 days
|
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Change of insulin secretion
Time Frame: 46 days
|
IVGTT performed at baseline, after intermittent fasting without weight loss and again after intermittent fasting with weight loss
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46 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Glycogen Content in Skeletal Muscle after a Day of Eating and after a Day of Fasting
Time Frame: 46 days
|
Analysis of glycogen content from muscle biopsies obtained after a day of fasting and after a day of eating during the intermittent fasting period.
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46 days
|
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Change from Baseline in Fat Content in the Liver and Visceral Fat after 20 Days of Intermittent Fasting
Time Frame: 23 days
|
Fat content measured by magnetic resonance spectroscopy.
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23 days
|
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Insulin signalling cascade proteins
Time Frame: 46 days
|
By Western blot determine any change in proteins relevant for insulin signalling and turnover of intramyocellular lipids.
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46 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Flemming Dela, MD, DMSc, University of Copenhagen
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Intermittent Fasting
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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