AzTrials
AzTrials

Type 2 Diabetes MellitusNCT05472272

Low-Calorie Diets on Type 2 Diabetes Remission

A study testing Formula diet and Food-based diet in people with Type 2 Diabetes Mellitus and Obesity, run by Shanghai Municipal Hospital of Traditional Chinese Medicine at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The prevalence of type 2 diabetes mellitus (T2DM) has been increasing rapidly in China. China currently has ~130 million diabetes cases, and over 90% are T2DM. T2DM is a leading cause of morbidity and mortality, posing substantial clinical and public health challenges. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Type 2 Diabetes Mellitus, Obesity, Overweight
What is being tested?
Formula diet and Food-based diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 siteChina
Study dates
3 Aug 2022to 18 Feb 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Physician-diagnosed T2DM
  • Most recent HbA1c level: 6.5%-12.0%
  • Body mass index: 24-45 kg/m2
  • Informed consent signed by participants in this study in accordance with requirements of local regulations and the Ethical Review Committee
  • No plan to leave Shanghai in 2 years

Who cannot join

  • Type 1 diabetes
  • Current use of insulin and glucagon-like peptide-1 receptor agonists
  • Major cardiovascular events (e.g., myocardial infarction, stroke, and heart failure) within the previous 6 months
  • Weight loss >5 kg within the past 6 months
  • Diagnosed eating disorders or any dieting behaviors
  • Chronic kidney disease stage 3b or higher (estimated glomerular filtration rate <30 milliliter /min/1.73m2)
Show all 15Show fewer
  • Previously diagnosed psychiatric disorders, e.g., schizophrenia, post-traumatic stress disorder, obsessive-compulsive disorder, uncontrolled depression, uncontrolled epilepsy
  • Severe arthritis and gout
  • Gallstone disease or known asymptomatic gallstones
  • Participation in another clinical research trial
  • Being pregnant or have a positive pregnancy test result at screening, or have given birth within the past 90 days, or who are breastfeeding.
  • Any known cancers
  • Learning difficulties
  • Alcoholism
  • Pancreatitis

Trial locations and contacts

1 site in 1 country.

China1 site
  • Department of Endocrinology, Shanghai Municipal Hospital of Traditional Chinese Medicine

    Shanghai, Shanghai Municipality, 200233

Other trials in China

About this study

Official title: Effect of Low-Calorie Diets on Remission of Type 2 Diabetes: A Feasibility Study

The prevalence of type 2 diabetes mellitus (T2DM) has been increasing rapidly in China. China currently has ~130 million diabetes cases, and over 90% are T2DM. T2DM is a leading cause of morbidity and mortality, posing substantial clinical and public health challenges. Reversing T2DM with a significant amount of weight loss via consuming a low-calorie diet is possible, but no studies have been conducted to determine whether low-calorie diets will help achieve significant weight loss and diabetes remission among Chinese patients with T2DM. The investigators design a pilot study to assess the feasibility of a low-calorie diet intervention program on weight loss and diabetes remission in a Chinese population with T2DM.

Read the detailed description

Consistent evidence has shown that overweight and obesity are the leading cause of T2DM, which exacerbates the development of insulin resistance and disease progression. For overweight and obese patients with T2DM, there is a strong consensus that sustained and moderate weight loss can effectively improve glycemic control and blood pressure as well as reduce the need for glucose-lowering medications and improve quality of life.

Short-term dietary interventions using structured low-calorie diets (800-1,000 kcal/day) have shown to be an effective approach for losing weight and promoting sustained diabetes remission in T2DM patients who are overweight or obese. The United Kingdom DiRECT research team designed a structured, intensive intervention program of 12-20 weeks to achieve substantial weight loss and T2DM remission through energy restriction. Researchers recorded ≥15 kg of weight loss in 24% of the participants who underwent a low-calorie formula diet intervention (total diet replacement with 825-853 kcal/day formula low-energy diet meal replacement products). Among these participants, the diabetes remission rate reached 90%.

This non-randomized dietary intervention study comprises 2 study arms: a formula diet (815-835 kcal/day) and a food-based diet (815-835 kcal/day). Participants will be on either of the two low-calorie diets for 12 weeks to achieve at least 12 kg of weight loss (intensive weight loss phase). Participants may extend the weight loss phase if desired. After 12 weeks, participants in the formula diet group are allowed to consume actual meals gradually, and participants in both groups will increase their energy consumption gradually over the next 12 weeks (weight loss achievement and maintenance phase). Physical activity is recommended during the second phase for maintaining weight loss. This study is designed to assess feasibility of the low-calorie diet intervention, in preparation for a full-scale randomized control study. This pilot study also plans to explore potential mechanisms of the intervention for weight loss and diabetes remission.

Being tested
Formula diet, Food-based diet
Keywords
Type 2 diabetes, Diabetes mellitus, Weight loss, Diet, Lifestyle intervention, Obesity
Medical subject headings
Diabetes Mellitus, Type 2, Obesity, Overweight, Diabetes Mellitus, Weight Loss

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Formula dietOther

    Participants will receive a low-calorie (815-835 kcal/day; approximately 43% carbohydrate, 29% protein, and 29% fat) formula diet product for 12 weeks, followed by a gradual food reintroduction phase combined with physical activity support for 12 weeks.

  • Food-based dietOther

    Participants will receive a low-calorie (815-835 kcal/day; 45-50% carbohydrate, 20-30% protein, and 20-30% fat) food-based diet created by dietitians for 12 weeks. After 12 weeks, participants will increase energy intake gradually and be encouraged to increase daily physical activity to maintain weight loss for another 12 weeks.

Study groups in NCT05472272
Study groupRoleWhat they receive
Formula DietExperimentalParticipants will receive a low-calorie formula diet product.
Receives: Other: Formula diet
Food-Based DietExperimentalParticipants will receive a low-calorie food-based diet created by dietitians.
Receives: Other: Food-based diet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percent of adherence to the intervention

    Percent of adherence is calculated at the end of the intervention by dividing the number of participants who remain in and adhere to the intervention by the total number of participants who participate in the intervention.

    Measured: Baseline to 24 weeks

  2. Percent of participants achieving significant weight loss and diabetes remission

    Proportion of participants achieving significant weight loss (≥12kg) and diabetes remission, which is defined as having a glycated hemoglobin (HbA1c) level less than 6.5% while receiving no pharmacological therapy for diabetes for at least 3 months, will be estimated at 24 weeks.

    Measured: Baseline to 24 weeks

Secondary outcomes (19)
  1. Aggregated safety assessment

    Glutathione, glutathione, total bilirubin, direct bilirubin, indirect bilirubin, urea nitrogen, creatinine, blood cell sorting count, urine routine, and adverse events are measured or recorded at the pre-specified time points to reflect number of participants with abnormal laboratory values and/or adverse events that are related to treatment.

    Measured: Baseline to 24 weeks

  2. Insulin sensitivity

    Insulin sensitivity is evaluated with insulin tolerance tests at the pre-specified time points.

    Measured: Baseline to 24 weeks

  3. Beta cell function

    Beta cell function is evaluated with arginine stimulation test at the pre-specified time points.

    Measured: Baseline to 24 weeks

  4. Level of fasting glucose

    Level of fasting glucose is measured using a blood sample from a finger stick when participants have an empty stomach (refraining from eating of drinking any liquids other than water for eight hours) at the pre-specified time points.

    Measured: Baseline to 24 weeks

  5. Level of postprandial glucose

    Level of postprandial glucose is measured using a blood sample from a finger stick two-hour later after participants eat their meals at the pre-specified time points.

    Measured: Baseline to 24 weeks

  6. Level of HbA1c

    Level of HbA1c is measured using a blood sample from a finger stick at the pre-specified time points.

    Measured: Baseline to 24 weeks

  7. Glucose homeostasis

    Time in Range, Time Above Range, and Time Below Range are measured at the pre-specified time points using continuous glucose monitor data.

    Measured: Baseline to 24 weeks

  8. Body fat composition and fat distribution

    Dual-energy X-ray absorptiometry scan is used for quantifying body composition. Magnetic resonance imaging scan is used to quantify fat in the liver and pancreas at the pre-specified time points.

    Measured: Baseline to 24 weeks

  9. Gut microbiota

    Metagenomic sequencing of fecal samples is performed to study gut microbiota including bacteria, fungi, archaea, and viruses at the pre-specified time points.

    Measured: Baseline to 24 weeks

  10. Traditional Chinese Medicine(TCM) tongue diagnosis estimated by tongue-face diagnosis instrument

    Parameters of tongue nature and tongue coating are estimated by tongue-face diagnosis instrument to detect hyperglycemic changes at the pre-specified time points.

    Measured: Baseline to 24 weeks

  11. TCM facial diagnosis estimated by tongue-face diagnosis instrument

    The changes of face complexion and surface gloss are estimated by tongue-face diagnosis instrument to reveal pathological changes of different viscera and bowels with different natures at the pre-specified time points.

    Measured: Baseline to 24 weeks

  12. Health-related quality of life

    The European Quality of Life 5-dimension 5-level questionnaire will be used to measure health-related quality of life at the pre-specified time points. The scale is numbered from 0 to 100. 100 measn the best health condition, and 0 means the worst health condition.

    Measured: Baseline to 24 weeks

  13. Diet

    The food frequency questionnaire will be used to assess diet and eating behaviors at the pre-specified time points.

    Measured: Baseline to 24 weeks

  14. Binge eating behaviors

    The binge eating scale will be used to assess the presence of binge eating behavior indicative of an eating disorder at the pre-specified time points (less than 17: non-binging; 18-26: moderate binging; 27 and greater: severe binging).

    Measured: Baseline to 24 weeks

  15. Diet and eating behaviors

    The three-factor eating questionnaire will be used to assess diet and eating behaviors at the pre-specified time points. All items are coded with either 0 or 1 point leading to maximum sum scores of 21 points for the domain of 'cognitive restraint', 16 points for 'disinhibition' and 14 points for 'hunger'. Higher scores indicate stronger characteristic values in the domains.

    Measured: Baseline to 24 weeks

  16. Psychological status-Anxiety

    The Self-Rating Anxiety Scale will be used to measure anxiety level at the pre-specified time points (20-44 normal range. 45-59 mild to moderate anxiety, 60-74 severe).

    Measured: Baseline to 24 weeks

  17. Psychological status-Depression

    Patient Health Questionaire-9 will be used to measure depression level at the pre-specified time points (0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe).

    Measured: Baseline to 24 weeks

  18. Sleep quality

    The Pittsburgh Sleep Quality Index will be used to measure sleep quality at the pre-specified time points. The scores range from 0 to 21 and a score >5 be considered as a significant sleep disturbance. Higher scores indicate worse sleep quality.

    Measured: Baseline to 24 weeks

  19. Metabolomic profiling performed by liquid chromatography mass spectrometry

    The liquid chromatography mass spectrometry (LC-MS) approach will be used to identify metabolites, pathways and networks that are associated with dietary interventions at the pre-specified time points. The major classes of metabolites including amino acids, carbohydrates, nucleotides, lipids, coenzymes, and cofactors are aggregated to demonstrate metabolic patterns.

    Measured: Baseline to 24 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jul 2022
  2. Study start3 Aug 2022
  3. Primary completion18 Feb 2024
  4. Study completion18 Feb 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
This is a non-randomized parallel study without a control arm
Masking
None (open label)
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05472272
Sponsor's protocol ID
SHMHTCM DM
Status last verified
May 2024
First submitted
9 Jul 2022
Last updated
16 May 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data materials will publish articles

Publications

  • Shi S, Wang S, Wu D, Li K, Yang G, Xu L, Feng N, Du X, Zhong VW. Epigenetic Signatures of Type 2 Diabetes Remission and Substantial Weight Loss: The Role of DNA Methylation in Response to Low-Calorie Diet Intervention. J Am Nutr Assoc. 2025 Nov-Dec;44(8):765-776. doi: 10.1080/27697061.2025.2513378. Epub 2025 Jun 5.

    PubMed 40471649
  • Liu Z, Feng N, Wang S, Liu Y, Wang J, Tan Y, Dong Y, Sun Z, Du X, Xu Y, Tao F, Zhong VW. Low-calorie diets and remission of type 2 diabetes in Chinese: phenotypic changes and individual variability. Nutr J. 2025 Mar 14;24(1):42. doi: 10.1186/s12937-025-01101-z.

    PubMed 40087696

Questions about this trial

What is this clinical trial studying?

A study testing Formula diet and Food-based diet in people with Type 2 Diabetes Mellitus and Obesity, run by Shanghai Municipal Hospital of Traditional Chinese Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 15 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percent of adherence to the intervention (time frame: Baseline to 24 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05472272, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2024; AzTrials last refreshed its copy on 1 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in