Chrono-restricted Diet and Physical Activity as a New Preventive Strategy for Sarcopenia in Postmenopausal Women With Obesity and Type 2 Diabetes

Not Applicable

Not yet recruiting

• Conditions: Obesity; Sarcopenia; Post Menopause; Type 2 Diabetes; Circadian Clock

• Registration Number: NCT07075133
• Lead Sponsor: University Hospital, Toulouse

Brief Summary

The aim of TIMEDIAB is to demonstrate that early TRE (eTRE) combined to late (afternoon) exercise will outperform eTRE combined to morning exercise on muscle function as primary endpoint, and glucose homeostasis as secondary endpoint

Detailed Description

Overweight, obesity, aging and menopause are all independent risk factors in the development of type 2 diabetes mellitus (T2DM). Older women with T2DM are at especially high risk for sarcopenia, i.e. loss of skeletal muscle mass and force, and cardiovascular diseases. The first line of T2DM treatment is based on lifestyle changes including weight loss and physical activity. One major current medical challenge is to find novel lifestyle therapies able to reduce cardiometabolic risk while perserving muscle mass in obese older individuals. As a result, intermittent fasting approaches, including time-restricted feeding/eating (TRF/TRE), have been offered as alternative dietary strategies that may have beneficial effects on weight control and T2DM. It has been recently observed that long-term TRF improve glucose homeostasis while perserving muscle mass and force in female obese mice. The purpose of TIMEDIAB is to demonstrate that early TRE (eTRE) combined to late (afternoon) exercise will outperform eTRE combined to morning exercise on various components of muscle health as primary endpoint, and blood glucose control, body composition, energy balance, cardiovascular risk, and metabolic health as secondary endpoints. This study will pave the way to larger scale randomized clinical trials investigating the long-term effects/benefits of such intervention and in other target populations.

Study Timeline

• Status Verified: 2025-06
• Study First Submitted: 2025-06-24
• Study First Submitted QC: 2025-07-10
• Last Update Submitted: 2025-07-10
• Study Start: 2025-07-15
• Study First Posted: 2025-07-20
• Last Update Posted: 2025-07-20
• Primary Completion: 2029-07-15
• Study Completion: 2029-07-15

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 45

Inclusion Criteria

• Post-menopausal women (amenorrhea for at least 12 months, confirmed by gonadotrophins measures)
• Age range 45-70 years
• T2DM diagnosed for more than 1 year
• Subjects with T2DM treated with lifestyle control alone or associated with metformine ± DPP4 inhibitors
• Ability to sign written informed consent before any study-specific procedure
• Subject considered as reliable and capable of adhering to protocol
• Subjects with Body Mass Index (BMI)≥ 30 kg/m²
• Baseline eating period ≥ 14 h per day (as estimated by 95% eating interval)

Exclusion Criteria

• Subjects on T2DM injectable medication or drugs able to induce hypoglycemia (glinides, sulfonylurea)

• Subjects with HbA1c > 8%

• Subjects with any of the following medical conditions:

  • Congestive cardiac failure
  • Stage 4 chronic kidney disease (i.e. eGFR < 30 ml/min/1.73 m2)
  • Liver cirrhosis or chronic liver disease
  • Any medical condition that in the opinion of the investigator could jeopardize or compromise the subject's ability to participate in the study

• Subjects with previous or present history of serious eating disorder

• Subjects not able to understand the informed consent form or fasting diary instructions

• Subjects currently participating or has participated in another study of an investigational medication or an investigational medical device within the last 30 days

• Women with menopause hormone replacement therapy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change in skeletal muscle function	4 years	Change in skeletal muscle function, assessed by 30-CTS score at inclusion (baseline) and 12 weeks after diet/exercise program; This test is used to assess lower limb strength. The score corresponds to the total number of standing positions correctly performed within the allotted 30 seconds.

Secondary Outcome Measures

Name	Time	Method
Change in muscle function	4 years	Change in muscle function assessed by various tests such as: 6 min walk test: At the 6th minute, the operator also notes the level of dyspnea.
• Change in M value measured by hyperinsulinemic euglycemic clamp	4 years	Systemic insulin sensitivity will be assessed using a euglycemic hyperinsulinemic clamp, oral hyperglycemia, and insulin signaling pathway studies. The M value (unitless measurement) determined during the clamp will be the marker of systemic insulin sensitivity.
Change in HbA1c, during an oral glucose tolerance test	4years	Change in HbA1c (in percentage), during an oral glucose tolerance test
Change in fasting glucose, during an oral glucose tolerance test	4years	Change in fasting glucose (g/l), during an oral glucose tolerance test
Change in 2h blood glucose, during an oral glucose tolerance test	4 years	Change in 2h blood glucose (g/l), during an oral glucose tolerance test
Change of the insulin resistance index (HOMA-IR)	4years	Change of the insulin resistance index (HOMA-IR) from fasting parameters: from fasting insulin levels (mU/mL) and fasting blood glucose levels (mmol/L)
Change of the insulin sensitivity index (HOMAβ)	4years	Change of the insulin sensitivity index (HOMAβ) from fasting parameters: from fasting insulinemia (mU/mL) and fasting blood glucose (mmol/L)
Change in body weight (kg)	4years
Change in body mass index (kg/m2)	4years
Change in waist circumference (cm)	4years
Change in waist-to-hip ratio (without unit)	4years
Change in body composition	4years	Change in body composition (fat mass, lean mass, bone mass, muscle mass)
Change in blood pressure	4years	Change in systolic and diastolic pressure (mmHg)
Change in plasma lipid profile	4years	Liver and muscle lipid content will be measured by MRI.
Change in visceral fat (kg)	4 years
Change in liver fat (kg)	4 years
Change in muscle fat (kg)	4 years

Trial Locations

Locations (1)

Rangueil Hospital; 🇫🇷 Toulouse, France