Does Intermittent Fasting Help With Diabetes?

About 537 million adults have diabetes worldwide, and the number keeps on getting higher. Lifestyle changes, including intermittent fasting, have proven to be a non-medicinal approach to manage diabetes effectively.

This comprehensive article will cover everything you need to know about intermittent fasting and diabetes, the pros and cons, the recommended fasting types, and tips on how to do intermittent fasting safely.

Key Takeaways:

• Studies have proven that intermittent fasting helps with diabetes.
• It improves blood glucose regulation and insulin resistance while reducing body fat and inflammation.
• 16/8 intermittent fasting is one of the safest and most effective methods to start.
• People with diabetes should seek their healthcare provider’s approval before starting.

Table of Contents:

• History of Intermittent Fasting and Diabetes
• Can Intermittent Fasting Help With Diabetes?
• Benefits of Intermittent Fasting for Diabetes
• Are There Downsides to Intermittent Fasting for Diabetes?
• Types of Intermittent Fasting for Diabetes
• Safe Ways to Do Intermittent Fasting With Diabetes
• Conclusion
• Frequently Asked Questions (FAQ)

History of Intermittent Fasting and Diabetes

Intermittent fasting has ancient roots, tracing back to various cultures and civilizations that practiced fasting for religious, spiritual, or health-related reasons. Fasting has been a part of human history as a means of purification, self-discipline, and cultural or religious observances.

The use of fasting to manage diabetes is debatable, as some scientists note some downsides, which we will cover later. However, current research data suggests intermittent fasting benefits people with diabetes.

Glucose Metabolism:

Before diving into the benefits and downsides, it’s crucial to understand how the body works. Glucose metabolism¹ is the process by which the body breaks down carbohydrates from food into glucose, the primary energy source, with the help of insulin.²

In a healthy individual, the pancreas releases insulin to facilitate glucose uptake by cells, where it is used for energy or stored for future use.

Disruptions in glucose metabolism can lead to diabetes. In Type 1 diabetes,³ the body doesn’t produce insulin, while in Type 2 diabetes,⁴ cells become resistant to insulin.⁵

Insulin Resistance:

In insulin resistance,⁶ cells become less responsive to insulin. This means that the sugar we eat can’t enter the tissue cells and accumulate in the blood, leading to elevated blood sugar levels. This condition is a precursor to Type 2 diabetes.⁷

Prediabetes:

Prediabetes⁸ is a condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as Type 2 diabetes. It serves as a critical stage for intervention to prevent the progression to full-blown diabetes.⁹

Often, prediabetes is a result of insulin resistance, which is reversible.¹⁰

However, it’s important to note that while fasting has the potential to reverse prediabetes and type 2 diabetes, it is not an effective management for type 1 diabetes, which is a type of autoimmune disorder.

Can Intermittent Fasting Help With Diabetes?

Yes, intermittent fasting has been scientifically proven to help with diabetes, especially managing sugar levels, improving insulin resistance, reducing body fat, preventing diabetes complications, and reducing inflammation.

However, it’s crucial to understand that the scientific data available are performed with medical supervision, and doing it without consulting your healthcare provider may be more detrimental than helpful.

Benefits of Intermittent Fasting for Diabetes

Managing Sugar Levels

For individuals with diabetes, effectively managing sugar levels is crucial. Intermittent fasting offers a structured approach to meal timing that aligns with insulin action, potentially aiding in better blood sugar control.

According to this research on patients with impaired glucose metabolism,¹¹ intermittent fasting reduced fasting blood glucose, HbA1c, and insulin levels among the subjects.

These results are supplemented by a systematic review¹² of published literature stating that intermittent fasting is an effective non-medicinal treatment option for type 2 diabetes.

Improving Insulin Resistance

Intermittent fasting may promote this sensitivity by reducing oxidative stress and inflammation and supporting the body’s ability to utilize insulin more efficiently.

Scientific studies exploring the relationship between intermittent fasting and insulin resistance have shown promising results.¹¹ Some research indicates that intermittent fasting can improve insulin sensitivity¹² and potentially reverse the early stages of insulin resistance.

The same review states that some patients were able to reverse their need for insulin therapy while doing supervised intermittent fasting.

Reducing Body Fat

Excess body fat, especially around vital organs, is linked to insulin resistance and an increased risk of Type 2 diabetes.

Studies show intermittent fasting is effective in weight loss and improved fat distribution¹³ among patients with obesity and diabetes. These results also came with better glycemic levels.

Preventing Diabetes Complications

Managing sugar levels and losing weight are among the best ways to prevent diabetes complications,¹⁴ two benefits you get when doing intermittent fasting.

Some of the most common diabetes complications¹⁵ include heart disease, nerve damage, and kidney disease, which all result from narrowing blood vessels due to continuous elevated blood sugar levels.

However, it’s important to note that to this date, no medication, including metformin and insulin, has proven to prevent complications entirely, and the best way to prevent them is by glycemic control.

Reducing Inflammation

Intermittent fasting has positive effects against inflammation,¹⁶ reduces excessive immune reactions and prevents oxidative stress.

People with diabetes always have to deal with inflammation brought about by the immune system reacting to the increased glucose levels. When not managed properly, the immune response causes chronic inflammation, which harms the body’s organs.

Are There Downsides to Intermittent Fasting for Diabetes?

Risk of Hypoglycemia and hyperglycemia

Intermittent fasting can lead to fluctuations in blood sugar levels. For individuals with diabetes, there’s a potential risk of hypoglycemia (low blood sugar), especially if medications are not adjusted accordingly.

On the other hand, there is also a possibility of a sugar spike during fasting, also known as fasting hyperglycemia,¹⁷ if the liver spares some glucose. When this happens, constant monitoring and medical advice are crucial.

Adjustment Period

If you’re new to intermittent fasting, you would most likely experience transitional symptoms which may include dizziness, nausea, insomnia, headache, weakness, and more frequency of urination.

You could also experience drying of the mouth and a certain smell of the breath. Increased hydration and reinforcing the fasting with a nutrition-rich meal are necessary.

Nutrient Deficiency

Prolonged fasting periods may result in reduced nutrient intake. This could lead to deficiencies in essential vitamins and minerals, impacting overall health and potentially exacerbating existing health conditions.

To combat this, ask your healthcare provider for supplements recommendations and maintain nutrient-rich meals.

Adherence Challenges

Intermittent fasting requires discipline and adherence to a specific eating schedule. Maintaining this regimen consistently may be challenging for some individuals, potentially leading to irregular eating patterns.

Potential Overeating

Some individuals may compensate for fasting periods by overeating during the designated eating windows. This can counteract the intended benefits and contribute to weight gain, which concerns diabetes management.

Types of Intermittent Fasting for Diabetes

Before diving into the types of intermittent fasting you could try for diabetes, it’s crucial to consult your healthcare provider for any changes in your lifestyle that may affect your blood sugar levels, especially when you want to try fasting.

16:8 Intermittent Fasting

16:8 Intermittent fasting is one of the safest and most effective forms¹⁸ as it allows the body to use fat as an energy source, reducing fat actively. However, some individuals may need more time to adjust to this.

This focuses on fasting for 16 hours and getting all the daily calorie requirements within the 8-hour eating period, usually between lunch and dinner.

5:2 Diet

The 5:2 diet is a safe and starter-friendly intermittent fasting¹⁹ that involves regular eating for five days a week and restricting calorie intake to around 500-600 calories on two non-consecutive days. On fasting days, individuals typically consume small, nutrient-dense meals or snacks.

Early time-restricted feeding (eTRF)

The Early Time-Restricted Feeding Diet²⁰ (eTRF) is a variant of time-restricted feeding where individuals limit their eating to an early time window within the day, typically finishing their last meal in the afternoon or early evening.

Safe Ways to Do Intermittent Fasting With Diabetes

The decision to do fasting when you have diabetes should not be taken lightly to avoid any complications. Here are a few tips to ensure safety in your intermittent fasting journey:

• Always seek medical advice: Do not start fasting without your healthcare provider’s approval. They should also keep track of your progress and should monitor metabolic changes for safety purposes.
• Start slow: Some people can’t tolerate the 16:8 right off the bat, so you can start with the 5:2 diet and work your way up there. Always listen to your body.
• Monitor sugar levels regularly: Monitoring your sugar levels will help you identify whether fasting works and notify you if you develop fasting hyperglycemia.
• Plan meals intentionally: During the eating period, intake nutrient-dense foods to ensure proper nutrition and prevent binge eating or snacking.

Conclusion

Intermittent fasting is an effective tool for managing diabetes and preventing its complications. It reduces glucose and lipid levels and increases insulin sensitivity.

The 16:8 approach, 5:2 diet, and eTFR are among the intermittent fasting forms to try. However, people with diabetes first seek their healthcare provider’s approval before starting with it.

Frequently Asked Questions (FAQ)

References

¹Nakrani MN, Wineland RH, Anjum F. Physiology, Glucose Metabolism. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560599/

²Vargas E, Joy NV, Carrillo Sepulveda MA. Biochemistry, Insulin Metabolic Effects. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK525983/

³Lucier J, Weinstock RS. Type 1 Diabetes. [Updated 2023 Mar 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507713/

⁴Goyal R, Singhal M, Jialal I. Type 2 Diabetes. [Updated 2023 Jun 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513253/

⁵Wilcox G. Insulin and insulin resistance. Clin Biochem Rev. 2005 May;26(2):19-39. PMID: 16278749; PMCID: PMC1204764.

⁶Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. [Updated 2023 Aug 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507839/

⁷Taylor, R. (2012). Insulin Resistance and Type 2 Diabetes. Diabetes, 61(4), 778-779. https://doi.org/10.2337/db12-0073

⁸Alvarez S, Coffey R, Algotar AM. Prediabetes. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459332/

⁹Mayans L. (2015). Metabolic Syndrome: Insulin Resistance and Prediabetes. FP essentials, 435, 11–16.

¹⁰Karam J. H. (1996). Reversible insulin resistance in non-insulin-dependent diabetes mellitus. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 28(9), 440–444. https://doi.org/10.1055/s-2007-979834

¹¹Yuan X, Wang J, Yang S, Gao M, Cao L, Li X, Hong D, Tian S, Sun C. Effect of Intermittent Fasting Diet on Glucose and Lipid Metabolism and Insulin Resistance in Patients with Impaired Glucose and Lipid Metabolism: A Systematic Review and Meta-Analysis. Int J Endocrinol. 2022 Mar 24;2022:6999907. doi: 10.1155/2022/6999907. PMID: 35371260; PMCID: PMC8970877.

¹²Albosta, M., & Bakke, J. (2021). Intermittent fasting: Is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians. Clinical Diabetes and Endocrinology, 7. https://doi.org/10.1186/s40842-020-00116-1

¹³Morales-Suarez-Varela, M., Sánchez, E. C., Peraita-Costa, I., Llopis-Morales, A., & Soriano, J. M. (2021). Intermittent Fasting and the Possible Benefits in Obesity, Diabetes, and Multiple Sclerosis: A Systematic Review of Randomized Clinical Trials. Nutrients, 13(9). https://doi.org/10.3390/nu13093179

¹⁴Rawal, L. B., Tapp, R. J., Williams, E. D., Chan, C., Yasin, S., & Oldenburg, B. (2012). Prevention of Type 2 Diabetes and Its Complications in Developing Countries: A Review. International Journal of Behavioral Medicine, 19(2), 121-133. https://doi.org/10.1007/s12529-011-9162-9

¹⁵Farmaki, P., Damaskos, C., Garmpis, N., Garmpi, A., Savvanis, S., & Diamantis, E. (2020). Complications of the Type 2 Diabetes Mellitus. Current Cardiology Reviews, 16(4), 249-251. https://doi.org/10.2174/1573403X1604201229115531

¹⁶Ojo, T. K., Joshua, O. O., Ogedegbe, O. J., Oluwole, O., Ademidun, A., & Jesuyajolu, D. (2022). Role of Intermittent Fasting in the Management of Prediabetes and Type 2 Diabetes Mellitus. Cureus, 14(9). https://doi.org/10.7759/cureus.28800

¹⁷Sheehan J. P. (2004). Fasting hyperglycemia: etiology, diagnosis, and treatment. Diabetes technology & therapeutics, 6(4), 525–533. https://doi.org/10.1089/1520915041705910

¹⁸Moro, T., Tinsley, G., Bianco, A., Marcolin, G., Pacelli, Q. F., Battaglia, G., Palma, A., Gentil, P., Neri, M., & Paoli, A. (2016). Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. Journal of Translational Medicine, 14. https://doi.org/10.1186/s12967-016-1044-0

¹⁹Hajek, P., Przulj, D., Pesola, F., McRobbie, H., Peerbux, S., Phillips-Waller, A., Bisal, N., & Smith, K. M. (2021). A randomised controlled trial of the 5:2 diet. PLoS ONE, 16(11). https://doi.org/10.1371/journal.pone.0258853

²⁰Kim, J., & Song, Y. (2023). Early Time-Restricted Eating Reduces Weight and Improves Glycemic Response in Young Adults: A Pre-Post Single-Arm Intervention Study. Obesity Facts, 16(1), 69-81. https://doi.org/10.1159/000527838