4.3. Strengths and Limitations
diabetic
IMPAIRED GLUCOSE TOLERANCE, RECRUITMENT
Given the limited evidence of the efficacy of TRE in individuals with IFG, our study contributes valuable knowledge to this field. The findings from our RCT can inform the recommendation of appropriate dietary interventions to reduce future diabetic risk. Furthermore, our study assessed the efficacy of BE-informed interventions to promote intervention adherence. This evidence is valuable for encouraging adherence not only to dietary but other interventional approaches.However, our study had several limitations. First, ongoing COVID-19 pandemic restrictions during the recruitment period resulted in a smaller sample size than anticipated which reduced the statistical power of our findings. Second, the participant adherence rate to the TRE protocol in our study was quite low. Consequently, the non-significant effectiveness of TRE in our study should be interpreted with caution given the poor intervention compliance. This is supported by the results from the “as-treated” analysis that point to potentially significant benefits of TRE for improving blood sugar and fasting insulin levels. Third, our interventions could not be blinded; hence, the findings may be subject to observer and information bias. However, the majority of our outcomes were objectively measured, and the assessors were blinded to allocation; thus, measurement error or ascertainment bias was minimized. In addition, our study did not measure oral glucose tolerant test. As a result, we were unable to determine the status of impaired glucose tolerance among the participants in the study. Lastly, only surrogate outcomes such as FPG, HbA1c, body weight, and other laboratory tests were assessed; thus, further RCTs that measure long-term or clinically important outcomes, such as DM incidence, are needed.