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Kronisk ernæring og insulinresistens ved diabetes (Chrono)

30. oktober 2026 oppdatert av: Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Effekten av en kronisk ernæringsintervensjon på insulinresistens hos voksne med type 2-diabetes

The goal of this randomized clinical trial is to determine the effect of a chrono nutrition intervention compared with a usual dietary intervention on insulin resistance in individuals with type 2 diabetes with overweight or obesity over a 6-month period.

The main question it aims to answer is: What is the effect of a chrono nutrition intervention compared to a standard intervention on insulin resistance in individuals with T2D (type 2 diabetes) with overweight or obesity over a 6-month period?

Participants:

  • Will be asked to fast for 12 hours each day. During the fasting period, they may consume non-caloric beverages such as plain water, coffee, or unsweetened tea.
  • They will be asked to follow a dietary plan in which the total daily calorie intake will be calculated using indirect calorimetry, subtracting 500 calories from the total calorie amount.
  • The dietary plan will have the following macronutrient distribution: 40% carbohydrates (<10% simple carbohydrates), 20% protein, and 40% fats (6-11% polyunsaturated, 15-20% monounsaturated, and <10% saturated).
  • The plan will consist of 3 meals: breakfast will account for 40% of the total calories. Dinner will include only 10% of the total grams of carbohydrates.
  • The order of food consumption should be: 1) vegetables, 2) proteins, 3) complex carbohydrates, and 4) simple carbohydrates (fruits).

Researchers will compare the chrono nutrition strategy with a standard dietary intervention to see the effect in insulin resistance.

Studieoversikt

Status

Aktiv, ikke rekrutterende

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Type 2 diabetes (T2D) is considered one of the main public health problems. During the last decade the incidence of T2D has increased exponentially leading to an increased incidence in cardiovascular disease, premature death, blindness and non-traumatic limb amputation. Novel therapeutic interventions have become imperative.

Dietary interventions are the cornerstone in managing and preventing T2D, however there is heterogeneity in the interventions and approaches currently available. The main objective of a dietary intervention is modest weight reduction achieved through calorie deficit and reduction in the consumption of carbohydrates and fats. Dietary interventions with a chrono nutrition focus establish an eating regime with calorie and macronutrient distribution taking into account sleeping and fasting hours, which are associated with metabolic alterations. This approach looks beyond calorie deficit and weight loss as primary outcomes.

Nutrition, physical activity, and education are fundamental pillars for achieving metabolic control in T2D. It is well-described that a nutritional treatment alone can improve glycemic control and the quality of life of patients. It is interesting to note that the timing of meals throughout the 24-hour period seems to play an important role, similar to the number of meals per day or the total calorie intake. Furthermore, the daily pattern of fasting-feeding is influenced by the sleep-wake cycle pattern, which is one of the most evident adaptations to circadian rhythms and plays a significant role in maintaining optimal health.

Interventions targeting aspects such as food type, meal timing, quality, and quantity can be a simple and promising strategy that can positively or negatively impact metabolic health, regardless of body weight modification. This evidence supports chrono nutrition as a novel strategy in the field of nutrition, primarily focusing on studying the interaction between nutrition, feeding, and the circadian rhythm. The implementation of new nutritional strategies based on circadian rhythms contributes to improving adherence to dietary treatment and preventing potential complications.

Studietype

Intervensjonell

Registrering (Antatt)

40

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Mexico
    • Mexico City
      • Mexico City, Mexico City, Mexico, 14080
        • Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 60 år (Voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Patients diagnosed with type 2 diabetes (T2D)
  • HbA1c < 8.5%
  • BMI ≥ 25 kg/m2 and < 35 kg/m2
  • Stable pharmacological treatment for the last 3 months
  • Willingness to participate in the protocol.

Exclusion Criteria:

  • Insulin treatment
  • Hospitalization in the previous three months
  • Disease with adverse prognosis (SIDA, cancer)
  • Rheumatologic diseases under immunosuppressive treatment (SLE, RA)
  • Acute infection or febrile syndrome
  • Hepatic cirrhosis
  • Glomerular filtration rate <60 ml/min
  • Other diabetes types (LADA, T1, MODY)
  • Fasting triglycerides >500 mg/dl
  • Pregnancy
  • Lactation
  • Steroid treatment
  • High performance athletes
  • Estrogen treatment
  • Weight reduction >5% in the last three months

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Chrono nutrition
  1. During the 6-month period, participants will be asked to fast for 12 hours each day. During the fasting period, they may consume non-caloric beverages such as plain water, coffee, or unsweetened tea.
  2. The total daily calorie intake will be calculated using indirect calorimetry, considering the participant's current weight, age, sex, and physical activity level. 500 calories will be subtracted from the total calorie amount.
  3. The dietary plan will have the following macronutrient distribution: 40% carbohydrates (<10% simple carbohydrates), 20% protein, and 40% fats (6-11% polyunsaturated, 15-20% monounsaturated, and <10% saturated).
  4. The plan will consist of 3 meals and breakfast will account for 40% of the total calories.
  5. During dinner, only 10% of the total grams of carbohydrates will be included.
  6. The order of food consumption should be as follows: 1) vegetables, 2) proteins, 3) complex carbohydrates, and 4) simple carbohydrates (fruits).
Annen: Chrono nutrition

An integral nutritional strategy involving timing, order and distribution of macronutrients
Aktiv komparator: Standard
  1. The total daily calorie intake will be calculated using indirect calorimetry, considering the participant's current weight, age, sex, and physical activity level. 500 calories will be subtracted from the total calorie amount.
  2. The dietary plan will have the following macronutrient distribution: 40% carbohydrates (<10% simple carbohydrates), 20% protein, and 40% fats (6-11% polyunsaturated, 15-20% monounsaturated, and <10% saturated).
  3. The plan will consist of 3 meals with an isocaloric distribution, with each meal containing 33% of the total calories.
Annen: Standard

Conventional nutritional strategy involving isocaloric distribution with no specific timing

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in insulin resistance (M value)
Tidsramme: Six months

Change in insulin resistance (M value) assessed with an euglycemic-hyperinsulinemic clamp.
Six months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in visceral adipose (liters)
Tidsramme: Six months

Change in visceral adipose tissue amount
Six months
Change in glycated hemoglobin (%)
Tidsramme: Six months

Change in glycated hemoglobin
Six months
Change in lipid profile (mg/dl)
Tidsramme: Six months

Change in lipid profile
Six months

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in hepatic steatosis and fibrosis (decibels and kilopascals)
Tidsramme: Six months

Change in hepatic steatosis and fibrosis assessed with elastography
Six months
Hunger and satiety (score)
Tidsramme: Six months

Change in hunger and satiety assessed with visual analog scale for hunger and satiety
Six months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. januar 2024

Primær fullføring (Antatt)

1. april 2027

Studiet fullført (Antatt)

1. august 2027

Datoer for studieregistrering

Først innsendt

5. oktober 2023

Først innsendt som oppfylte QC-kriteriene

30. november 2023

Først lagt ut (Faktiske)

8. desember 2023

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

3. november 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

30. oktober 2026

Sist bekreftet

1. oktober 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 4494

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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