Time Restricted Eating in Patients With Microalbuminuria

Inclusion criteria

• Age: 18-75 years old
• Participants with T2DM with A1c between 6.5 and 9.0 % and on stable doses of medications who are weight-bearing and self-ambulatory.
• uACR ( urine albumin creatinine ratio) results ≥ 30 - 300 mg.
• Willingness to use smartphone for research procedures (Apple iOS or Android OS)
• Baseline eating period ≥12 hours/day and sufficient logging on the mCC app.
• Person of childbearing potential will be given a pregnancy test on study enrollment and asked to use contraception throughout the study.
• Post-menopausal and individuals on hormone replacement therapy will be included.
• Estimated Glomerular Filtration Rate (EGFR) \> 45
• If participants are on cardiovascular medications (HMG CoA reductase inhibitors (statins), other lipid-modifying drugs, anti-hypertensives) no dose adjustments will be allowed during the study period
• Participants on stable doses (consistent dose for ≥3 months) of GLP-1 receptor agonists will be included.

Exclusion criteria

• Participants with Type1DM and T2DM who are taking insulin, sulfonylureas, or have an HbA1c \> 9 %.
• Estimated Glomerular Filtration Rate (EGFR) \< 45
• Systolic BP greater than 160 mmHg and/or Diastolic BP greater than 110 mmHg (with or without treatment/medication)
• LDL cholesterol greater than 200 mg/dL
• Triglycerides greater than 500 mg/dL
• Active tobacco or illicit drug use
• Pregnant or breastfeeding individuals.
• Currently enrolled in a weight-loss or weight-management program,
• Currently on a special or prescribed diet for other reasons (e.g., Celiac disease),
• On recently prescribed medication that is meant for weight loss, or has known effect on appetite suppression ( patient on stable dose for 3 months can be enrolled ).
• History of eating disorder(s).
• History of surgical intervention for weight management (e) active eating disorder.
• Chronic kidney disease with an eGFR calculated based on the Modification of Diet in Renal Disease (MDRD) equation \<50mL/min/1.73m2
• Treatment for active inflammatory and/or rheumatologic disease and cancer.
• A major adverse cardiovascular event within the past 6 months such as acute coronary syndrome (ACS), percutaneous coronary intervention, coronary artery bypass graft surgery, hospitalization for congestive heart failure, stroke/transient ischemic attack (TIA).
• History of Uncontrolled arrhythmia (i.e., rate-controlled atrial fibrillation/atrial flutter are not exclusion criteria) 18. Liver cirrhosis and/or significant alterations in liver function
• History of (a) thyroid disease requiring dose titration of thyroid replacement medication(s) within the past 3 months (i.e., hypothyroidism on a stable dose of thyroid replacement therapy is not an exclusion), Shift workers with variable (e.g., nocturnal) hours.
• Caregivers for dependents requiring frequent nocturnal care/sleep interruptions.
• More than one trip planned to travel to a time zone with greater than a 3-hour difference during study period.
• History of major adverse cardiovascular events within the past 1 year (acute coronary syndrome (ACS), percutaneous coronary intervention, coronary artery bypass graft surgery, hospitalization for congestive heart failure, stroke/transient ischemic attack (TIA)).
• History of thyroid disease requiring dose titration of thyroid replacement medication(s) within the past 3 months (i.e., hypothyroidism on a stable dose of thyroid replacement therapy is not an exclusion).
• History of adrenal disease.
• History of malignancy undergoing active treatment, except non-melanoma skin cancer.
• Known history of type I diabetes.
• History of stage 4 or 5 chronic kidney disease or requiring dialysis.
• History of HIV/AIDS.
• Uncontrolled psychiatric disorder (including history of hospitalization for psychiatric illness).