- βLifetime model shows a 60% probability the FMD programme is cost-effective compared to usual care
- βLong-term diabetes complication savings largely offset the higher upfront programme costs
- βSupports patients on lifestyle-only or metformin treatment as a potential add-on strategy
| Journal | BMC primary care |
| Year | 2025 |
| Authors | van den Burg, van Peet, Schoonakker |
| PMID | 41214519 |
What Was Studied and Why It Matters
Managing type 2 diabetes is expensive β for patients and healthcare systems alike. Researchers in the Netherlands wanted to know whether a fasting-mimicking diet (FMD) programme could not only improve health but also be worth the money compared to standard diabetes care.
The FMD involves eating a special low-calorie, plant-based diet for just 5 consecutive days each month, then returning to normal eating for the rest of the month. The study looked at adults with type 2 diabetes who were managing their condition with lifestyle advice alone or lifestyle advice plus metformin β a common first-line medication.
What the Researchers Did
The team analyzed data from 92 patients and used two approaches:
- A trial-based analysis β looking at actual costs and quality of life over the one-year study period
- A lifetime model β projecting long-term outcomes including heart disease risk and death rates using a well-established diabetes forecasting tool
They measured success using quality-adjusted life-years (QALYs) β a way of capturing both how long someone lives and how good their quality of life is during that time.
What They Found
In the First Year
The news wasn't immediately encouraging. Over the one-year trial period, patients in the FMD group had slightly lower quality-of-life scores (though this difference was too small to be statistically meaningful) and significantly higher healthcare costs β about β¬2,241 more than those receiving usual care. In the short term, the programme did not appear to be cost-effective.
Looking at a Lifetime Picture
Here's where things get more interesting. When researchers projected outcomes over a patient's entire lifetime, the FMD group showed a modest gain in quality-adjusted life, and the extra costs largely evened out β because fewer diabetes complications meant lower long-term healthcare spending. The lifetime cost per quality-of-life year gained came to approximately β¬8,369, and there was about a 60% chance the programme would be considered cost-effective by standard healthcare benchmarks.
What This Means for Real Patients
If you have type 2 diabetes and are managing it with lifestyle changes or metformin, a monthly 5-day fasting-mimicking diet may not feel affordable or practical in year one. However, this research suggests the approach could pay off over time by helping to prevent costly complications like heart disease.
Sticking to any diabetes management plan β whether that includes dietary strategies, medication, or monitoring β requires the right tools and support. At MDS Diabetes, we make it easier to stay on track by providing reliable diabetes supplies, so you can focus on your health without added stress.
It's also worth noting that the study was small (just 92 participants), so these results should be treated as early-stage evidence rather than a firm recommendation.
Bottom Line
A monthly 5-day fasting-mimicking diet costs more upfront in the first year but may become cost-effective over a lifetime by reducing serious diabetes complications. Speak with your doctor before trying any fasting approach, especially if you take diabetes medications, as dietary changes can affect blood sugar levels significantly.