Typically, doctors advise people with type 2 diabetes to eat about six times a day. But this approach can lead to a vicious cycle in which individuals require more intensive treatments. Could a different approach to diet be more suitable?

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Type 2 diabetes is one of the most common metabolic conditions. Across the globe, over 400 million people live with it.

Usually, doctors prescribe drugs that will help individuals with diabetes keep their blood sugar levels under control, as well as advise them on how to change their dietary habits to aid treatment.

Many healthcare providers believe that the best approach for people with type 2 diabetes is to eat more, smaller meals at regular intervals throughout the day. Typically experts recommend eating six times a day.

However, this approach can lead to problems. Some people who follow this type of diet plan require more intensive treatments. This is particularly true of those with severe forms of diabetes who need to inject themselves with high doses of insulin to counterbalance insulin resistance.

However, high-dosage insulin injections can introduce glucose (blood sugar) level imbalances. They can also cause weight gain and lead to a higher risk of cardiovascular problems.

Recently, a team of researchers from Tel Aviv University in Israel has hypothesized that eating according to a person’s natural “body clock” — which typically calls for three larger meals a day — might help physiological processes to synchronize better and reduce the amount of insulin a person requires.

Weight loss and improved blood sugar

“The traditional [diet for people with diabetes] specifies six small meals spread throughout the day,” says Prof. Daniela Jakubowicz. “But [this diet],” she adds, “has not been effective for sugar control, so [people with diabetes] require additional medication and insulin. And insulin injections lead to weight gain, which further increases blood sugar levels.”

Prof. Jakubowicz and team have now conducted a study confirming that the three meals a day approach could be more helpful for those with type 2 diabetes.

“[O]ur research proposes shifting the starch-rich calories to the early hours of the day. This produces a glucose balance and improved glycemic control among [people with type 2 diabetes],” the specialist explains.

“We believe that through this regimen, it will be possible for [people with diabetes] to significantly reduce or even stop the injections of insulin, and most antidiabetic medications, to achieve excellent control of glucose levels.”

Prof. Daniela Jakubowicz

In their study paper — which features in the journal Diabetes Care — the investigators note that they based their findings on a trial involving 28 participants with type 2 diabetes.

The researchers split the participants into two groups and randomly assigned them to follow either the typical six meals a day diet or the newly devised three meals a day diet.

In the three meals a day approach, participants had to follow a diet plan that is supposedly more in line with humans’ natural inclination to eat more in the morning, and fast in the evening and during the night.

This diet requires eating a breakfast of bread, fruit, and sweets early in the morning, having a sizeable lunch, and a small meal at dinnertime, which must not feature any starchy foods, sweets or fruit.

The team assessed the participants’ body weight, blood sugar control, appetite, and circadian clock (body clock) gene expression both at baseline, and then again at 2 weeks after the start of the trial, and at 12 weeks after.

Prof. Jakubowicz and team observed that the participants with diabetes who followed the typical six meal diet did not lose any weight and did not see better blood sugar control. However, those who ate three meals a day saw the opposite effect: they lost weight and had much improved blood sugar levels.

“Their need for diabetic medication, especially for insulin doses, dipped substantially. Some were even able to stop using insulin altogether,” notes Prof. Jakubowicz.

“In addition, the [three meal diet] improved the expression of biological clock genes. This suggests that the […] diet is not only more effective in controlling diabetes. It may also prevent many other complications, such as cardiovascular disease, aging, and cancer, which are all regulated by the biological clock genes,” Prof. Jakubowicz hypothesizes.