Among patients with type 2 diabetes (T2D), those who eat two meals per day exhibit higher greater intrapancreatic fat deposition than those who consume three meals per day, a study has found.
The study included 185 T2D patients who were hospitalized at Osaka University Hospital and underwent abdominal CT imaging during hospitalization. Self-administered questionnaires and medical records provided information relevant to the study. Researchers measured mean CT values for the pancreas (P), liver (L), and spleen (S), and the visceral fat area (VFA), and quantified intrapancreatic and liver ectopic fat accumulation as P−S and L−S, respectively.
The median age of participants was 63 years, the median body mass index (BMI) was 26.5 kg/m2, and the median HbA1c was 74.0 mmol/mol (8.9 percent). Twenty-two patients (13.3 percent) reported eating two meals per day, while 163 ate three meals per day; 147 participants (87.0 percent) said they also consumed snacks.
Of the 22 patients who only had two meals per day, 14 skipped breakfast, five skipped lunch, two skipped dinner, and one ate at 18:00 and 0:00. With respect to exercise, 68 patients (43.9 percent) said they engaged in daily exercise and 20 (14.8 percent) performed manual labour. There were 34 patients (18.4 percent) who were current smokers, and 36 (19.5 percent) who consumed >20 g/day alcohol. Twenty-two patients (12.4 percent) reported regularly experiencing insomnia, 33 (20.6 percent) had sleep apnoea syndrome, and six (4.4 percent) undertook night shifts.
The median VFA of the participants was 118.1 cm2. In an analysis adjusted for potential confounders, patients who consumed two meals per day had significantly lower P−S (higher intrapancreatic fat deposition; p=0.02) than those who consumed three meals per day.
No significant associations were noted between the number of meals consumed and liver ectopic fat accumulation and VFA (p=0.73 and p=0.67, respectively).
The findings back the current guideline for diabetes treatment that skipping meals should be avoided.


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