“This study is the first to compare the effects of three different dietary interventions intermittent energy restriction (IER), time-restricted eating (TRE) and continuous energy restriction (CER) in managing type 2 diabetes with obesity,” said Haohao Zhang, Ph.D., chief physician at The First Affiliated Hospital of Zhengzhou University in Zhengzhou, China.

Although researchers identified improved HbA1c levels, and adverse events were similar across the three groups, the IER group showed greater advantages in reducing fasting blood glucose, improving insulin sensitivity, lowering triglycerides, and strengthening adherence to the dietary interventions.

“The research fills a gap in directly comparing 5:2 intermittent energy restriction with a 10-hour time-restricted eating in patients with obesity and type 2 diabetes. The findings provide scientific evidence for clinicians to choose appropriate dietary strategies when treating such patients,” Zhang said.

Zhang and colleagues performed a single-center, randomized, parallel-controlled trial at the First Affiliated Hospital of Zhengzhou University from November 19, 2021 to November 7, 2024.

Ninety patients were randomly assigned in a 1:1:1 ratio to the IER, TRE or CER group, with consistent weekly caloric intake across all groups. A team of nutritionists supervised the 16-week intervention.

Of those enrolled, 63 completed the study. There were 18 females and 45 males, with an average age of 36.8 years, a mean diabetes duration of 1.5 years, a baseline BMI of 31.7 kg/m², and an HbA1c of 7.42%.

At the end of the study, there were no significant differences in HbA1c reduction and weight loss between the IER, TRE and CER groups. However, the absolute decrease in HbA1c and body weight was greatest in the IER group.

Compared to TRE and CER, IER significantly reduced fasting blood glucose and triglycerides and increased the Matsuda index, a measure of whole-body insulin sensitivity. Uric acid and liver enzyme levels exhibited no statistically significant changes from baseline in any study group.

Two patients in the IER group and the TRE group, and three patients in the CER group, experienced mild hypoglycemia.

The IER group had the highest adherence rate (85%), followed by the CER group at 84% and the TRE group at 78%. Both the IER and CER groups showed statistically significant differences compared with the TRE group.

Zhang said these findings highlight the feasibility and effectiveness of dietary interventions for people who have obesity and type 2 diabetes.

Losing muscle (or lean mass) is a common side effect of weight loss in adults with obesity and may negatively affect metabolism and bone health. This is because muscle helps control blood sugar after meals and plays an important role in keeping bones strong, according to study lead researcher Melanie Haines, M.D., of Massachusetts General Hospital and Harvard Medical School in Boston, Mass.

Approximately 40% of the weight lost from taking semaglutide — a type of weight-loss medication known as a GLP-1 — comes from lean mass, including muscle. It is not yet known who is at highest risk for muscle loss or how it affects blood sugar levels, Haines said.

The researchers studied 40 adults with obesity for three months. Of these patients, 23 were prescribed semaglutide, while 17 followed a diet and lifestyle program for weight loss called Healthy Habits for Life (HHL). The researchers evaluated how their muscle mass changed.

Study participants who were prescribed semaglutide lost more weight than those who participated in the diet and lifestyle program, but the percent of weight loss that was lean mass was similar between the two groups.

After accounting for weight loss, the researchers found that in the semaglutide group, being older, female or eating less protein was linked to greater muscle loss. Also in this group, losing more muscle was linked to less improvement in blood sugar (HbA1c levels).

“Older adults and women may be more likely to lose muscle on semaglutide, but eating more protein may help protect against this,” Haines said. “Losing too much muscle may reduce the benefits of semaglutide on blood sugar control. This means preserving muscle during weight loss with semaglutide may be important to reduce insulin resistance and prevent frailty in people with obesity.”

Haines said that more studies are needed to find the best way to lose fat but keep muscle when using GLP-1 medications.

“Obesity is a significant risk factor for breast cancer, and while it is very preliminary data, our studies in mice suggest that these new anti-obesity drugs may be a way to reduce obesity-associated breast cancer risk or improve outcomes,” said study author Amanda Kucinskas, B.S., a Ph.D. candidate in the labs of Drs. Erin Giles and Kanakadurga Singer at the University of Michigan in Ann Arbor, Mich.

Existing research has shown that having obesity can lead to worse breast cancer outcomes compared to those who do not have obesity, and weight loss can improve outcomes. However, there are many challenges with traditional weight loss methods.

Kucinskas and colleagues leveraged tirzepatide, one of a new class of effective anti-obesity medications that target GLP-1 (glucagon-like peptide 1) and GIP (glucose-dependent insulinotropic polypeptide) receptors. The researchers sought to learn whether or not tirzepatide would reduce obesity-associated breast cancer growth.

This mouse study included 16 mice. The 9-week-old C57BL/6 mice were fed a 40% high-fat diet and housed in a warm environment to induce obesity. At 32 weeks of age, the mice with obesity were randomly assigned injections of tirzepatide or a placebo every other day for 16 weeks. Tumor volumes were measured twice weekly.

The researchers found that the anti-obesity drug reduced body weight and body fat by approximately 20% in mice, similar to the amount of weight loss achieved by women on this drug. They found this was primarily due to a loss of adipose mass, with a reduction in adipose depot weights compared to controls.

The anti-obesity drug also reduced tumor volume compared to the controls. At the end of the study, the researchers found that tumor volume was significantly correlated with body weight, total adipose mass and the amount of fat stored in the liver.

“While these are very preliminary results, they suggest that this new anti-obesity drug may also have a beneficial impact on breast cancer outcomes,” Kucinskas said.

Ongoing studies are underway in collaboration with Dr. Steve Hursting’s lab at the University of North Carolina at Chapel Hill to separate the weight loss from the tumor-specific effects of tirzepatide.

Scientists from the University of South Australia (UniSA) have developed a long-acting injectable formulation that delivers a steady dose of levodopa and carbidopa – two key medications for Parkinson’s – over an entire week.

Their findings have been reported in the journal Drug Delivery and Translational Research.

The biodegradable formulation is injected under the skin or into muscle tissue, where it gradually releases the medication over seven days.

Parkinson’s disease is the second most common neurological disorder, affecting more than 8.5 million people worldwide. Currently there is no cure and the symptoms – tremors, rigidity and slow movement – are managed with oral medications that must be taken several times a day.

The frequent dosing is a burden, especially for elderly patients or those with swallowing difficulties, leading to inconsistent medication levels, more side effects, and reduced effectiveness.

Lead researcher Professor Sanjay Garg, from UniSA’s Centre for Pharmaceutical Innovation, says the newly developed injectable could significantly improve treatment outcomes and patient adherence.

“Our goal was to create a formulation that simplifies treatment, improves patient compliance, and maintains consistent therapeutic levels of medication. This weekly injection could be a game-changer for Parkinson’s care,” Prof Garg says.

“Levodopa is the gold-standard therapy for Parkinson’s, but its short life span means it must be taken several times a day.”

UniSA PhD student Deepa Nakmode says the in-situ implant is designed to release both levodopa and carbidopa steadily over one week, maintaining consistent plasma levels and reducing the risks associated with fluctuating drug concentrations.

“After years of focused research, it’s incredibly rewarding to see our innovation in long-acting injectables for Parkinson’s disease reach this stage. Our invention has now been filed for an Australian patent,” Nakmode says.

The injectable gel combines an FDA-approved biodegradable polymer PLGA with Eudragit L-100, a pH-sensitive polymer, to achieve a controlled and sustained drug release.

Extensive lab tests confirmed the system’s effectiveness and safety:

• More than 90% of the levodopa dose and more than 81% of the carbidopa dose was released over seven days.
• The implant degraded by over 80% within a week and showed no significant toxicity in cell viability tests.
• The formulation can be easily administered through a fine 22-gauge needle, minimising discomfort and eliminating the need for surgical implant.

“The implications of this research are profound,” Prof Garg says. “By reducing the frequency of dosing from multiple times a day to a weekly injection is a major step forward in Parkinson’s therapy. We’re not just improving how the drug is delivered; we’re improving patients’ lives.”

Prof Garg says the technology could also be adapted for other chronic conditions such as cancer, diabetes, neurodegenerative disorders, pain management, and chronic infections that require long-term drug delivery.

The system can be tuned to release drugs over a period ranging from a few days to several weeks depending on therapeutic needs.

UniSA scientists hope to start clinical trials in the near future and are exploring commercialisation opportunities.