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We examined the efficacy, feasibility and safety of eTRC in individuals with type 2 diabetes under free-living conditions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this randomised, parallel-arm, open label, controlled trial, participants with type 2 diabetes and overweight\/obesity (age 67.2\u00b17.9 years, 47.8% women, BMI 29.4\u00b13.7 kg\/m<jats:sup>2<\/jats:sup>, HbA<jats:sub>1c<\/jats:sub> 49\u00b15 mmol\/mol [6.6\u00b10.5%]) were randomised, using computer-generated random numbers, to a 12 week eTRC diet or a Mediterranean-style control diet with matched energy restriction and macronutrient distribution (50% carbohydrate, 30% fat and 20% protein). The primary outcome was the between-group difference in HbA<jats:sub>1c<\/jats:sub> at 12 weeks. Body composition, 14 day flash glucose monitoring and food diary analysis were performed every 4 weeks. Mixed meal tolerance tests with mathematical beta cell function modelling were performed at baseline and after 12 weeks.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Twelve (85.7%) participants in the eTRC arm and 11 (84.6%) participants in the control arm completed the study, achieving similar reductions in body weight and fat mass. The two groups experienced comparable improvements in HbA<jats:sub>1c<\/jats:sub> (\u22123 [\u22126, \u22120.3] mmol\/mol vs \u22124 [\u22126, \u22122] mmol\/mol, corresponding to \u22120.2 [\u22120.5, 0]% and \u22120.3 [\u22120.5, \u22120.1]%, respectively, <jats:italic>p<\/jats:italic>=0.386), fasting plasma glucose, flash glucose monitoring-derived glucose variability and mixed meal tolerance test-derived glucose tolerance, insulin resistance, insulin clearance and plasma glucagon levels, without changes in model-derived beta cell function parameters, glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide and non-esterified fatty acid levels. The two diets similarly reduced liver function markers and triglyceride levels, being neutral on other cardiometabolic and safety variables. In exploratory analyses, diet-induced changes in body weight and glucometabolic variables were not related to the timing of carbohydrate intake.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>The proposed eTRC diet provides a feasible and effective alternative option for glucose and body weight management in individuals with type 2 diabetes, with no additional metabolic benefits compared with conventional dieting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>ClinicalTrials.gov NCT05713058<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Funding<\/jats:title>\n                <jats:p>This study was supported by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the Italian Society of Diabetology (SID).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-023-06045-9","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T05:01:46Z","timestamp":1700110906000},"page":"263-274","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Early time-restricted carbohydrate consumption vs conventional dieting in type 2 diabetes: a randomised controlled trial"],"prefix":"10.1007","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7633-1346","authenticated-orcid":false,"given":"Domenico","family":"Tric\u00f2","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Masoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-4238","authenticated-orcid":false,"given":"Simona","family":"Baldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Cimbalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7005-1215","authenticated-orcid":false,"given":"Luca","family":"Sacchetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-2295","authenticated-orcid":false,"given":"Maria Tiziana","family":"Scozzaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Nesti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2834-9725","authenticated-orcid":false,"given":"Alessandro","family":"Mengozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0560-6496","authenticated-orcid":false,"given":"Lorenzo","family":"Nesti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0174-4549","authenticated-orcid":false,"given":"Martina","family":"Chiriac\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8465-7717","authenticated-orcid":false,"given":"Andrea","family":"Natali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,11,16]]},"reference":[{"issue":"5","key":"6045_CR1","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1007\/s00125-023-05873-z","volume":"66","author":"NG Forouhi","year":"2023","unstructured":"Forouhi NG (2023) Embracing complexity: making sense of diet, nutrition, obesity and type 2 diabetes. 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Mari (National Research Council, Padova, Italy) for kindly proving the tools for beta cell function modelling and fruitful discussions, to S. Frascerra and S. Pinnola (Laboratory of Metabolism, Nutrition, and Atherosclerosis, University of Pisa, Pisa, Italy) for their assistance in the preparation and conduction of metabolic tests and to M. Fruzzetti (University of Pisa, Pisa, Italy) for her help in the interpretation of food diaries. The authors are also grateful to the study volunteers for their generous contribution to this project.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"Data generated in this study are available from the corresponding authors upon request.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"This study was supported by the European Society for Clinical Nutrition and Metabolism (ESPEN Research Fellowship to DT) and the Italian Society of Diabetology (Research Fellowships to DT and AN).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"DT, MCM and AN designed the study. DT, MCM, SB, NC, LS, MTS, GN, AM, LN and MC performed the experiments, contributed to data analysis and drafted the manuscript. DT and AN reviewed and edited the manuscript. All authors have read and approved the final version of the manuscript. AN is responsible for the integrity of the work as a whole.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}