For People With Type 2 Diabetes, Intermittent Fasting May Have Major Benefits

It’s no secret that intermittent fasting is the weight-loss method du jour. Instagram is packed with people who swear intermittent fasting (IF) helped them lose weight, feel more energized, and have better overall health.

But with all of the info out there about intermittent fasting, it’s easy to gloss over the fact that IF has actually been a used as a medical intervention for years. It’s helped people with a range of health conditions, including diabetes.

In fact, the American Diabetes Association (ADA), which is considered the leading educational organization for diabetes in the country, published this in its journal Diabetes in 2018: “In both experimental and clinical studies, intermittent fasting has been shown to improve insulin sensitivity and glucose control along with modest decreases in body weight.”

And last year, the ADA released a nutrition consensus report that also addressed intermittent fasting. In it, the ADA wrote that some—but not all—small studies have shown that intermittent fasting reduced A1C in people with diabetes. (A1C is a measure of your average blood sugar over time.) Still, there isn’t a mainstream, blanket recommendation for diabetes patients when it comes to intermittent fasting for better health, but there does seem to be some link here.

So what’s the deal with intermittent fasting and diabetes, and should you try the eating pattern if you have the condition? Doctors weigh in.

Here’s what we know about whether intermittent fasting may be an effective tool for diabetes management.

Again, this isn’t an eating plan that’s widely recommended by diabetes specialists, but there is some data to suggest IF could help with diabetes management.

A case report published in BMJ found that intermittent fasting helped treat the insulin resistance in three patients with insulin-dependent type 2 diabetes. It also lowered their A1C levels. And, this is definitely worth paying attention to: After using intermittent fasting for several months, the patients were able to stop using their insulin medication.

Intermittent fasting may even help with prediabetes. A clinical trial published in the journal Cell Metabolism that had men with prediabetes try intermittent fasting. Some were asked to follow a plan for five weeks where they could eat for six hours a day; the others were asked to eat for 12 hours a day. Those who followed the six-hour eating plan ended up having less insulin resistance at the end vs. those who followed the more regular 12-hour eating pattern.

But all of that said, a meta-analysis of research on intermittent fasting published in the journal Cell Metabolism found that intermittent fasting had the same results on a person’s insulin resistance and A1C as eating a diet with limited calories.

Basically, “there is no evidence that intermittent or any other type of fasting is better than caloric restriction in losing weight,” says Mark H. Schutta, MD, medical director of the Penn Rodebaugh Diabetes Center. And, he points out, weight loss can help reduce a patient’s insulin resistant and A1C levels, regardless of how it was achieved.

The research on the impact of intermittent fasting and diabetes isn’t perfect, says Lissette Céspedes, MD, assistant professor of medicine in the Division of Endocrinology at Rutgers Robert Wood Johnson Medical School. “In clinical studies, the study sizes have generally been small and the follow up period is short,” she says. “Studies also vary by which method of fasting is employed. As such, long-term benefit and generalizability cannot be determined.”

All in all, it's unclear if intermittent fasting is helpful for any other reason than the fact that it may help you cut calories, since you're eating in a shorter window of time.

These are the notable benefits of doing intermittent fasting.

While some people swear that intermittent fasting will completely change your life, those claims are a little overblown. Still, there’s some research to suggest that IF has perks. Those include:

  • Weight loss. This has a bit of an asterisk. While research has found a link between intermittent fasting and weight loss, there isn’t much proof that IF is better than any other diet for weight loss. One meta-analysis published in the JBI Database of Systematic Reviews and Implementation Reports, for example, found that intermittent fasting had similar weight-loss results to a traditional calorie-restricted diet. “Generally due to a reduced window of eating, caloric intake tends to be lower,” Dr. Céspedes explains.
  • Lowered blood pressure. The Cell Metabolism study of men with prediabetes also found that the men who followed a 16:8 schedule of intermittent fasting significantly lowered their blood pressure.
  • Appetite control. It seems a little odd that restricting when you eat can help but research has linked lower levels of hunger with IF. A study published in the journal Obesity found that people who only ate during a six-hour window felt less hungry than the control group, who followed a normal eating pattern. That was true even though both groups ate the same amount of calories.

    There isn’t really one set intermittent fasting schedule that’s best for people with diabetes.

    A lot if it comes down to personal preference. “Patients need to work with their physician to find a plan that works best for them [that] poses the fewest risks, and that they can sustain over a long period of time,” Dr. Céspedes says.

    That said, a 16:8 schedule may be easiest to follow and the most beneficial for maintaining good blood glucose control—and several studies have found this eating pattern to be beneficial. “I often tell my patients that the most impactful change they can make is to eat less at dinner, go to bed with a normal or close to normal glucose, and then wake up with the same,” Dr. Schutta says.

    But, again, “There truly is no one-size fits all approach to selecting a regimen for patients with diabetes who want to improve their insulin resistance and glucose metabolism,” Dr. Céspedes says.

    Intermittent fasting does come with potential side effects that anyone with diabetes should know about.

    Intermittent fasting isn’t perfect, and there are some side effects to consider.

    • It can mess up your hunger cues. That can cause you to overeat when you’re in a feeding window. That’s a problem for anyone, but especially for someone with diabetes, Dr. Schutta says, noting that this can lead to elevated glucose levels. Regularly having elevated, uncontrolled glucose levels can lead to complications like nerve damage, eye issues, kidney disease, and stroke, per the ADA.
    • Low blood sugar. On the flip side, people with diabetes risk having low blood sugar (hypoglycemia) during fasting periods, Dr. Céspedes says. That can lead to symptoms like headaches, dizziness, trouble concentrating, nervousness, irritability, and uncoordinated movements.

      Here are some tips for doing intermittent fasting for diabetes management.

      If you’re interested in trying intermittent fasting to better manage your diabetes, it’s important to talk to your doctor first, Dr. Céspedes says. They may have some concerns you haven’t thought of, and may even need to adjust your medication.

      It’s also important to think about what you’re eating during a feeding window. “In general, we recommend that patients eat a healthy diet, which will improve their cardiometabolic risks,” Dr. Céspedes says. “This includes increasing intake of fresh foods, such as fruits and vegetables, and complex carbohydrates and minimizing highly processed foods or simple carbohydrates.”

      The quality of your calories matters too, Dr. Céspedes says. “A person with diabetes should also take into consideration the amount of carbohydrates being consumed in the diet,” she says. “Generally, eating fewer than about 150 grams of carbohydrates in a day will improve blood glucose levels, insulin resistance, and help with weight loss.”

      Complex carbohydrates with a higher fiber content, like using cauliflower instead of white rice, are better options since “these are absorbed more slowly and lead to less glucose excursions,” Dr. Céspedes says. Given that you’ll probably be ready to eat as soon as your feeding window starts, it’s important to plan ahead to make sure you have quality food ready to go once your fasting period is over.

      Finally, you’ll want to create eating and fasting windows that work best for your diabetes management. Breakfast is “truly the most important meal of the day” for people with diabetes, Dr. Schutta says (your body is better able to process glucose when you’re up and moving). But you’ll want to make sure you’re actually hungry in the morning and not still full from a huge dinner you ate. "Patients have to figure out a way to restrict food after dinner and make sure that they eat breakfast every day,” Dr. Schutta says.

      The bottom line: If you’re interested in trying out intermittent fasting to help manage your diabetes, talk to your doctor first. They should be able to offer up personalized advice to help steer you in the right direction.


      Post a Comment