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ORIGINAL RESEARCH article

Front. Nutr.

Sec. Nutrition and Metabolism

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1648314

This article is part of the Research TopicDietary Prevention and Management of Type-2 DiabetesView all articles

Real-World Effect of Intermittent Calorie-restricted Diet on Type 2 Diabetes Remission: A Dual-Cohort Retrospective Study

Provisionally accepted
Zhiyong XiaoZhiyong Xiao1,2Xinhong YinXinhong Yin3Xihu LaiXihu Lai4Xu ZhouXu Zhou1,5Yewu ZhangYewu Zhang6Dongliang YangDongliang Yang7Ruiyu WuRuiyu Wu1,8Huiqing WangHuiqing Wang9Jiali ZhouJiali Zhou1,8Xiao YangXiao Yang1Bin ZhouBin Zhou10Wu LuoWu Luo1,5Xuan ChenXuan Chen1,5Liu DongboLiu Dongbo1,5,8*
  • 1Horticulture College, Hunan Agricultural University, Changsha, China
  • 2School of Nursing, University of South China, Hengyang, China
  • 3University of South China School of Nursing, Hengyang, China
  • 4Xincheng Smart Internet Hospital, Chengdu, China
  • 5Yuelushan laboratory, Changsha, China
  • 6Chinese Center for Disease Control and Prevention, Beijing, China
  • 7Department of General Education Courses, Cangzhou Medical College, Cangzhou, China
  • 8Hunan Provincial Engineering Research Centre of Medical Nutrition Intervention Technology for Metabolic Diseases, Changsha, China
  • 9Hepatobiliary and Pancreatic Surgery Department, First Affiliated Hospital of University of South China, Hengyang, China
  • 10Department of Endocrinology, Central Hospital of Shaoyang, Shaoyang, China

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Randomized controlled trials (RCTs) have demonstrated that intermittent calorie-restricted diet (ICR) can lead to diabetes remission. We aimed to assess the diabetes remission with ICR among patients with type 2 diabetes (T2D) in real-world settings.We performed a retrospective, dual-cohort study (January 2022 -July 2023) using real-world data from Chinese patients with T2D. The ICR cohort consisted of 1,069 patients following an intermittent calorie-restricted diet, while the control cohort consisted of 1,099 patients receiving Dietary Guidelines for Diabetes in China ( 2017Edition). The primary outcome was diabetes remission. Secondary outcomes included reductions in antidiabetic medication use and changes in fasting blood glucose (FBG).Subgroup evaluations for the sensitivity analysis were conducted to further assess outcomes. The study employed a combination of univariate and multivariate analyses, including Linear Mixed-Effects Models (LMM), Generalized Linear Mixed-Effects Models (GLMM), and Cox regression with propensity score-weighted Inverse Probability Weighting (IPW), to evaluate relationships between cohort and outcomes.In real-world settings, the ICR cohort achieved significantly higher remission rates (20% vs. 2%, p<0.001), greater medication reduction (61% vs. 22%, p<0.001). After IPW adjustment, ICR remained superior for remission (OR: 11.02, 95% CI: 8.12 -14.96) and reduce medication usage (Estimate: 6.26, 95% CI: 5.61-6.99, p<0.001).Subgroup analyses confirmed consistent benefits across FBG levels and diabetes durations.This study demonstrated the practical efficacy of ICR in achieving diabetes remission.These findings establish dietary interventions as a powerful and viable strategy for T2D remission

Keywords: dual-cohort retrospective study, Diet, intermittent calorie-restricted diet, Diabetes remission, Real-world

Received: 17 Jun 2025; Accepted: 04 Sep 2025.

Copyright: © 2025 Xiao, Yin, Lai, Zhou, Zhang, Yang, Wu, Wang, Zhou, Yang, Zhou, Luo, Chen and Dongbo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Liu Dongbo, Horticulture College, Hunan Agricultural University, Changsha, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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