A 60-year-old woman with a decade-long history of type 2 diabetes mellitus presented to the endocrinology clinic. Her medical history included occlusive coronary arteriosclerosis with angioplasty and stent support, coronary artery bypass grafting, hyperlipidemia, and obesity (body mass index, 30.2). At the initial visit, the patient's hemoglobin A1c was 11.5%, and her blood glucose level was 216 mg/dL. She was counseled on the benefits of chrononutrition, a feeding program in which major meals are scheduled between 4:00 am and 4:00 pm to align nutrient consumption with the circadian rhythm of major metabolic organs.1-3 To facilitate this lifestyle change, an appetite suppressant regimen was initiated using 37.5 mg of phentermine and 10 mg of fluoxetine, both given once daily, along with insulin glargine, insulin lispro, and metformin. Blood glucose levels improved within 10 days of treatment.
The patient followed up 1 month later with sustained glucose levels in a desirable range as indicated by her glucose meter readings (image). This case highlights the swift effect of chrononutrition on glycemic control, further affirming its positive metabolic effects.4,5
1. Zarrinpar A , ChaixA, PandaS. Daily eating patterns and their impact on health and disease. Trends Endocrinol Metab. 2016;27(2):69-83. doi:10.1016/j.tem.2015.11.007Search in Google Scholar PubMed PubMed Central
2. Zhou D , WangY, ChenL, et al. Evolving roles of circadian rhythms in liver homeostasis and pathology. Oncotarget. 2016;7(8):8625-8639. doi:10.18632/oncotarget.7065Search in Google Scholar PubMed PubMed Central
3. Karthikeyan R , MarimuthuG, SpenceDW, et al.Should we listen to our clock to prevent type 2 diabetes mellitus?Diabetes Res Clin Pract.2014;106(2):182-190. doi:10.1016/j.diabres.2014.07.029Search in Google Scholar PubMed
4. Mezitis NHE , BhatnagarV. Chrononutrition applied to diabetes management: a paradigm shift long delayed. Diabetes Spectr. 2018;31(4):349-353. doi:10.2337/ds18-0014Search in Google Scholar PubMed PubMed Central
5. Sutton EF , BeylR, EarlyKS, CefaluWT, RavussinE, PetersonCM. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3. doi:10.1016/j.cmet.2018.04.010Search in Google Scholar PubMed PubMed Central
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