Clinical Images  |   July 2019
Chrononutrition and the Diabetic Patient
Author Notes
  • From the Ohio University Heritage College of Osteopathic Medicine in Athens, Ohio. 
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Christopher Radlicz, OMS III, MS, MPH, Ohio University Heritage College of Osteopathic Medicine, 105 Parks Hall, Athens, OH 45701-1359. Email:
Article Information
Endocrinology / Imaging / Diabetes / Clinical Images
Clinical Images   |   July 2019
Chrononutrition and the Diabetic Patient
The Journal of the American Osteopathic Association, July 2019, Vol. 119, 469. doi:
The Journal of the American Osteopathic Association, July 2019, Vol. 119, 469. doi:
A 60-year-old woman with a decade-long history of type 2 diabetes mellitus presented to the endocrinology clinic. Her medical history included occlusive coronary arteriosclerosis with angioplasty and stent support, coronary artery bypass grafting, hyperlipidemia, and obesity (body mass index, 30.2). At the initial visit, the patient's hemoglobin A1c was 11.5%, and her blood glucose level was 216 mg/dL. She was counseled on the benefits of chrononutrition, a feeding program in which major meals are scheduled between 4:00 am and 4:00 pm to align nutrient consumption with the circadian rhythm of major metabolic organs.1-3 To facilitate this lifestyle change, an appetite suppressant regimen was initiated using 37.5 mg of phentermine and 10 mg of fluoxetine, both given once daily, along with insulin glargine, insulin lispro, and metformin. Blood glucose levels improved within 10 days of treatment. 
The patient followed up 1 month later with sustained glucose levels in a desirable range as indicated by her glucose meter readings (image). This case highlights the swift effect of chrononutrition on glycemic control, further affirming its positive metabolic effects.4,5 
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