Different eating patterns can help people with obesity and type 2 diabetes manage their blood sugar and lose weight, according to a new study shared at the Endocrine Society’s ENDO 2025 meeting in San Francisco.
The study compared three popular dietary approaches: intermittent energy restriction (IER), time-restricted eating (TRE), and continuous energy restriction (CER).
Dr. Haohao Zhang, chief physician at The First Affiliated Hospital of Zhengzhou University in China, led the research. He explained that this is the first study to directly compare these three strategies in people with obesity and type 2 diabetes.
The results showed that while all three diets helped reduce blood sugar (HbA1c) levels and weight, intermittent energy restriction had the strongest overall effects.
The IER group had better improvements in fasting blood sugar, insulin sensitivity, and blood fat levels like triglycerides. People in this group also stuck to their diets better than those in the TRE or CER groups.
The study included 90 adults randomly assigned to one of the three diet groups. Each group had the same total calorie intake over a week.
A team of nutritionists monitored the participants during the 16-week trial. By the end, 63 participants had completed the study—18 women and 45 men, with an average age of about 37 and a baseline BMI of 31.7. Most had been living with type 2 diabetes for just over a year.
All three groups saw similar drops in HbA1c and body weight, but the IER group showed the largest actual decreases in both. The IER diet followed a 5:2 pattern—five days of normal eating and two days of low-calorie intake. The TRE group ate only within a 10-hour window each day, while the CER group followed a consistent daily calorie restriction.
Although there were a few cases of mild low blood sugar (hypoglycemia) in all groups, there were no serious side effects. Uric acid and liver enzymes remained stable in all participants.
Adherence rates were also best in the IER group, with 85% sticking to the plan, compared to 84% in the CER group and 78% in the TRE group. The differences in sticking with the diet were especially notable between IER/CER and TRE.
Dr. Zhang noted that the findings help fill a gap in our understanding of how different diet plans work for people managing both obesity and type 2 diabetes. He said the results give doctors clearer options for choosing the best dietary strategy for their patients.
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