Effects of time-restricted eating on people with type 2 diabetes: a systematic review and meta-analysis

Long-term dietary adherence remains a challenge in the management of type 2 diabetes (T2DM). Time-restricted eating (TRE), a dietary strategy that confines daily food intake to a specific time window, has emerged as a potential intervention. However, its efficacy in individuals with T2DM remains unclear. This review aimed to comprehensively evaluate the effects of TRE in this population. A systematic search of PubMed, Embase, Scopus, Web of Science, and the Cochrane Library was conducted from inception to April 7, 2025, for interventional studies on TRE in adults with T2DM. Outcomes encompassed glucose metabolism, body weight, lipid profiles, dietary intake, sleep, and other physiological indicators. Data were pooled using random-effects model. The review included 12 studies involving 344 participants. TRE significantly reduced HbA1c (MD: -0.32%, 95% CI: -0.47 to -0.18) and fasting blood glucose (MD: -0.44 mmol/L, 95% CI: -0.68 to -0.19). Continuous glucose monitoring (CGM) data corroborated these improvements, showing an increased time in range (MD: 8.92%, 95% CI: 3.94 to 13.91) and a decreased time above range (MD: -11.42%, 95% CI: -15.53 to -7.30). These glycemic improvements were accompanied by a reduction in the medication effect score (MD: -0.15, 95% CI: -0.27 to -0.03). Furthermore, TRE led to improvements in weight-related indicators (body weight, BMI, and waist circumference) and in cardiovascular metabolic parameters, such as reductions in triglycerides and blood pressure (all p<0.05). In contrast, TRE did not significantly affect cholesterol levels or total sleep duration (all p ≥ 0.05), but was associated with prolonged sleep latency (SMD: 0.74, 95% CI:0.22 to 1.26). TRE represents a promising dietary intervention for individuals with T2DM, associated with improved glycemic control, weight management, and certain cardiovascular metabolic indices, alongside a potential reduction in medication requirements. However, it did not affect cholesterol or total sleep time and may prolong sleep latency. Further high-quality research is warranted to confirm these findings and optimize its clinical application.