Guide to eating well: Is intermittent fasting safe for people with diabetes?


Fasting is popular around the world; many religions practice it occasionally. Lately, a form of fasting, known as intermittent fasting (IF), has received a lot of attention as an effective way to lose weight. IF is constantly promoted by celebrities, fitness enthusiasts, and influencers who claim it’s a quick way to lose weight.

Scientific evidence supports the use of IF for weight loss. Based on a literature review conducted in 2021 on intermittent fasting and obesity, diabetes and multiple sclerosis, IF appears to have beneficial effects on lipid profile, while also being associated with weight loss in obese and diabetic patients from kind 2.

Additionally, the authors noted that glycemic levels were better controlled. According to this research, IF may aid in weight loss, thereby reducing the risk of diabetes-related complications. The question remains, however, whether people with diabetes can practice IF safely. Based on the evidence published so far, it appears that IF can be done safely, but people with diabetes are at risk of hypoglycaemia and hyperglycaemia caused by blood sugar fluctuations during and after periods without eating. Let’s explore this further.

What is Intermittent Fasting?

The SI diet involves limiting your meals to a fixed window of time followed by a fixed period of eating little or nothing. The fast can last from a few hours to several days. The regimen involves alternating cycles of eating and fasting. Perhaps it’s popular because it doesn’t fundamentally change “what” you eat, but “when” you eat. You can also choose from six different types of fasting. Fasting for 16 hours followed by eating for eight hours is the most popular intermittent fasting.

Two or three meals of equal proportions or two large meals and three small snacks can be eaten during this window. The other popular method is the 5:2 intermittent fasting diet, which involves eating normally for five days of the week and eating 500 to 600 calories on the other two days. The eat-stop-eat method involves a full 24-hour fast once a week. Fasting allows the consumption of water, black coffee and zero-calorie beverages. Another popular method of intermittent fasting is alternate fasting (ADF), which promotes a fasting day and a meal day. A modified version of the ADF allows you to consume about 500 calories on fasting days.

Intermittent fasting and diabetes – benefits

Type 2 diabetes is the result of prolonged insulin resistance, characterized by high blood sugar and several complications. ADF and intermittent fasting have been shown to reduce insulin resistance and lower blood sugar.

A study 2019 observed beneficial results after 6 hours of eating followed by 18 hours of fasting, including decreased inflammation, reduced insulin levels, improved markers of diseases such as asthma and arthritis, as well as a reduction in damaged cells, which could increase the risk of cancer.

Lipid profile and blood pressure levels were also improved. A small study from 2021 found that IF reduced insulin resistance in 13 adults with type 2 diabetes. This study also reported diabetes remission within five months, with an effectiveness rate high by 85%. Another opinion reported that most available research demonstrates that intermittent fasting is effective in reducing body weight, decreasing fasting blood sugar, reducing fasting insulin, reducing insulin resistance, decreasing leptin levels, and increasing adiponectin levels. Some studies have shown that patients were able to reverse their need for insulin therapy during intermittent fasting treatment protocols under the supervision of their doctor. A Case report 2018 involving 3 diabetic patients demonstrated the efficacy of therapeutic fasting in reversing their insulin resistance, leading to discontinuation of insulin therapy while maintaining blood sugar control. Additionally, these patients were also able to lose significant amounts of body weight, reduce waist circumference, and lower glycated hemoglobin levels.

According to these studies, IF can decrease insulin resistance and improve markers of diabetes. There is, however, a lack of research so far to determine whether it is an effective measure to control diabetes or not. There are also risks.

Intermittent fasting and diabetes – potential risks

Diabetic patients may be exposed to intermittent fasting. If you are using insulin or medications and suddenly reduce your portion sizes, your blood sugar can drop dramatically, leading to hypoglycemia. According to the American Diabetes Association (ADA), low blood sugar can cause tremors, confusion, irritability, sweating, chills, dizziness, and more. People who skip meals can also make poor food choices, which can negatively affect their waistline and blood sugar levels.

A high-carb pasta or pasta dish may seem more appealing if you haven’t eaten in hours. Bolus eating can lead to hyperglycemia and multiple complications. Animal studies indicate that IF may impact insulin sensitivity and pancreatic function. A experimental study published in 2020 found that alternate day fasting for 12 weeks led to increased belly fat, damage to insulin-producing pancreatic cells and signs of insulin resistance in rats.

Bottom Line – Intermittent fasting can lead to weight loss. However, it is not proven to help people with diabetes stop using insulin or control their blood sugar. More research is warranted. It is important to note that IF can cause hypoglycemia and hyperglycemia in diabetics due to blood sugar fluctuations during and after periods of fasting. Consult your doctor and diabetes care team before you start fasting. You can lose weight safely and sustainably.

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