Time-Restricted Eating in Youth With New-Onset Type 1 Diabetes: Feasibility, Acceptability, and Effect on β-Cell...

Minimal literature exists on time-restricted eating (TRE) in youth with type 1 diabetes (T1D). Following diagnosis, TRE may preserve β-cell activity by reducing metabolic stress and promoting mitochondrial health. We sought to assess the feasibility, acceptability, safety, and efficacy of TRE in youth with new-onset T1D.

For 8 weeks, youth (ages 12-25 years) with T1D (≤12 months) ate within an 8-h window and fasted for 16 h (late-TRE). Feasibility was assessed through enrollment, retention, adherence (daily logs), and acceptability (weekly interviews and questionnaires). Safety was evaluated by hypoglycemia frequency (<70 mg/dL) on continuous glucose monitoring. Efficacy was assessed by C-peptide area under the curve (mixed-meal tolerance test), time in range, and HbA_1c.

Twelve of 54 eligible participants (22%) enrolled (mean age 15.33 ± 2.02 years; HbA_1c 7.08 ± 1.37%; 66% Hispanic; 58% female; 58% public insurance). Ten were assigned to TRE (60% Hispanic, 30% White non-Hispanic, 40% female, 60% publicly insured), with 100% (10 of 10) completion and 88.57% adherence. No adverse events or change in hypoglycemia frequency occurred. Although TRE participants showed no significant changes on average (C-peptide: Δ = -9.62, P = 0.69; HbA_1c: Δ = -0.46, P = 0.17), C-peptide increased (Δ = 121.95, P = 0.001) and HbA_1c decreased (Δ = -1.20%, P = 0.04) significantly in those with higher baseline BMI (≥25 kg/m², n = 5).

High retention, adherence, and acceptability suggest TRE in youth with T1D is feasible; however, the low enrollment rate questions feasibility. Low rates of hypoglycemia suggest safety. These findings will inform larger TRE trials in youth with T1D.