For patients with type 2 diabetes, eating more food at breakfast and lunch may be more beneficial than eating the same caloric restriction split into six smaller meals per day, according to researchers.

To compare the effect of six small (A6) and two large (B2) meals on body weight, hepatic fat content, insulin resistance, and beta cell function in 54 patients with type 2 diabetes being treated with oral hypoglycemic agents, Hana Kahleova, MD, and colleagues from the Institute for Clinical and Experimental Medicine, randomly assigned patients to 12 weeks of either the A6 or the B2 diet (27 patients each). The findings were published in Diabetologia.

Researchers found that body weight decreased significantly in both regimens, with a greater decrease in the B2 group than the A6 group (-2.3 kg vs. -2.0 kg; P<0.001). In response to both regimens, hepatic fat content decreased significantly, with a greater decreases observed for B2 than A6 (-0.04% vs. -0.03%; P=0.009).

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In both regimens, fasting plasma glucose and C-peptide levels decreased significantly, with greater decreases observed with the B2 diet (P=0.004 and 0.04, respectively). There was a significant decrease in fasting plasma glucose with the B2 diet, and a significant increase with the A6 diet. In both diets, oral glucose insulin sensitivity increased significantly, more so for B2 (P=0.01). No adverse effects were observed.

“These results suggest that, for type 2 diabetic patients on a hypoenergetic diet, eating larger breakfasts and lunches may be more beneficial than six smaller meals during the day,” concluded the researchers.


  1. Kahleova H et al. Diabetologia. 2014; doi: 10.1007/s00125-014-3253-5