Objective: To compare intermittent energy restriction with continuous energy restriction on glycemic control and weight loss in patients with type 2 diabetes over 12-months . Design: Adults (N = 137) with type 2 diabetes were randomized 1:1 to intermittent energy restriction [n = 70] or continuous energy restriction [n = 67]). Interventions: An intermittent energy restriction diet (500~600 kcal/d) for 2 nonconsecutive days per week (with usual diet for 5 days) or a continuous energy restriction diet (1200~1500 kcal/d) for 12 months. Main Outcomes and Measures: The primary outcome was change in hemoglobin A1c (HbA1c) level, with equivalence prespecified by a 90% CI margin of ± 0.5%. Results: Of the 77 women and 60 men (mean [SD] BMI, 36.0 [5.8], HbA1c , 7.3% [1.3%]), 97 completed the trial. Intention-to-treat analysis showed similar reductions in HbA1c l with a between-group difference of 0.2% (90% CI, -0.2% to 0.5%) meeting the criteria for equivalence. Weight change was similar between the continuous and intermittent energy restriction groups (-5.0 [0.8] kg vs -6.8 [0.8] kg; P = .25), but equivalence was not met (-1.8 kg; 90% CI, -3.7 to 0.07). There were no significant differences in glucose levels or lipid levels. Hypoglycemic or hyperglycemic events in the first 2 weeks were similar between groups affecting 35% of participants using sulfonylureas and/or insulin. Conclusions: Intermittent energy restriction is an effective alternative diet strategy for the reduction of HbA1c and is comparable with continuous energy restriction in patients with type 2 diabetes.