Most fad diets fall short of expectations, much alone when put under rigorous scientific review. However, it appears that intermittent fasting is an exception. These diets, which can last anywhere from 16 hours to several days, include abstaining from calorie-dense meals and beverages for an extended length of time. They are useful for losing weight, according to research.
The course of the disease as well as blood glucose and insulin sensitivity can both benefit from weight loss, which is frequently recommended by doctors to persons with Type 2 diabetes. Experts are actively examining the effects of intermittent fasting among those with Type 2 diabetes for this and other reasons. There are certain safety issues, though. According to Benjamin Horne, director of cardiovascular and genetic epidemiology at Intermountain Healthcare in Utah, those with diabetes should be the ones who gain the most from intermittent fasting. But because persons with diabetes generally take medications, these diets also pose some of the biggest potential safety risks.
Recent articles on the effects of intermittent fasting among diabetics have been co-authored by Horne. One of them explicitly examined the risk profile of these practises and was published in the Journal of the American Medical Association in 2020. Our primary focus was on the safety concerns related to fasting when you already have a diabetic treatment plan in place because it is so simple to start an intermittent fasting programme on your own, according to the author. Horne claims that the research demonstrates that intermittent fasting is both safe and probably advantageous for the majority of persons with Type 2 diabetes—particularly those who are not taking drugs to regulate their blood sugar. However, not everyone should practise intermittent fasting.
The dangers of intermittent fasting
Low blood sugar, also known as hypoglycemia, can result in symptoms such a quick heartbeat, perspiration, shakiness, and others. If it is severe, it may result in seizures, death, or extreme weakness. One of the first risks that specialists considered while evaluating the safety of intermittent fasting was the increased risk of hypoglycemia in people with Type 2 diabetes, especially if they go for extended periods without eating. When combined with fasting, drugs intended to lower blood glucose levels can result in potentially dangerous hypoglycemia, according to Horne. “It poses a significant safety risk.”
In a 2018 study published in the journal Diabetic Medicine, researchers from New Zealand discovered that those with Type 2 diabetes who tried intermittent fasting did have an increase in the prevalence of hypoglycemia. The results of alternative weight-loss programmes, including traditional strategies that encourage people to consume less calories each day, were in line with this trend, though. The participants in the study were also all taking medications to lower their blood sugar levels. The hypoglycemia was brought on by the medications rather than the food itself, according to research author Brian Corley, a diabetes specialist at the Capital & Coast District Health Board in New Zealand.
According to Corley, those who use these medications can lower their chances of experiencing dangerous blood sugar reductions by working closely with a doctor, keeping a closer eye on their blood sugar levels on fast days, and learning how to handle a hypoglycemic episode. In other words, these patients don’t inherently rule out intermittent fasting plans; they just need a little extra consideration. In the meanwhile, his research revealed that intermittent fasting promoted weight loss and enhanced assessments of haemoglobin A1C, fasting blood sugar, and general quality of life.
For people who aren’t taking drugs to lower their blood sugar, Horne says the risk of hypoglycemia seems to be very low. “People should still consult with someone who treats diabetes—a physician such as an endocrinologist, or at least a nutritionist who is trained in diabetes treatment,” he says. Like Corley, he says even people on blood-sugar medications could attempt intermittent fasting so long as they are working with an expert. “It’s not so much should they or shouldn’t they. It’s more the degree to which they should be monitored,” he says. (That does not extend to patients with Type 1 diabetes; Horne says that for this group, intermittent fasting is too risky.)
Dehydration is a secondary important problem after hypoglycemia. People with Type 2 diabetes are already at an increased risk of dehydration because high blood glucose induces generalised dehydration in the body. If people are drinking less or eating less than they normally would, intermittent fasting may raise these risks even more. (It turns out that food can supply up to one third of the water that people need each day.)
People with diabetes “can have a variety of negative outcomes with dehydration,” according to Horne. Potential issues include stroke, renal damage, and migraine headaches, particularly if a diabetic already has underlying medical conditions that increase their risk.
So, he says, “Dehydration can potentially be harmful if someone already has a problem with their kidneys—and frequently, people with diabetes have some sort of kidney issue, if not full-blown kidney disease.” People who have Type 2 diabetes combined with other chronic diseases—such as heart disease or kidney disease—should certainly avoid trying fasting diets, although drinking water or other noncaloric liquids while fasting can lessen these risks. The same is true for diabetics who are elderly and fragile. “Fasting puts stress on the body and organs,” he claims. Going without eating is probably a poor choice if you’re weak or ill.
Intermittent fasting appears to be safe for the majority of persons with Type 2 diabetes when done under expert supervision, while hidden risks may still exist.
The advantages of intermittent fasting
While intermittent fasting may have hazards for some people, it may also have advantages over other methods. According to a 2017 study published in the World Journal of Diabetes, merely two weeks of intermittent fasting resulted in substantial weight loss (more than 3 lb on average) and improvements in blood glucose levels. According to Kerry Mansell, co-author of that study and a professor in the College of Pharmacy and Nutrition at the University of Saskatchewan in Canada, intermittent fasting may result in lessened insulin resistance.This theory is supported by research. Intermittent fasting may improve insulin sensitivity and lower blood levels of insulin, according to some research on diabetics. This is significant. Fasting essentially achieves the same goal as diabetic drugs, which is to increase insulin sensitivity, according to Horne. Adopting an intermittent fasting diet helped diabetic patients to completely discontinue taking their insulin medications, according to at least one short trial (including just three individuals). The results of that study still need to be verified in a bigger sample size. These kinds of outcomes, though, are encouraging. Higher levels of inflammation and other cardiovascular disease risk factors are linked to insulin resistance. According to certain studies, fasting significantly increases insulin sensitivity even when patients don’t lose weight, adds Horne. “With other caloric-restriction diets, you typically don’t see this,” she said.
How could fasting bring about these advantages? There are various theories, and some of them may out to be accurate. One of the most popular theories, which is already backed by substantial research, holds that fasting initiates a kind of cellular cleansing process that eliminates old or sick cells and promotes the growth of new ones. Some specialists contend that the human body isn’t built for the present food environment and its three meals plus snacks per day eating regimen based on this research. According to some, intermittent fasting may be more similar to how people have generally eaten throughout the history of our species.
To make sense of anything, more work is required. However, evidence to date suggests that intermittent fasting may offer distinct and significant health benefits for those with Type 2 Diabetes.
Which fasting plan is the most effective?
There is no specific practise that is meant when the word “intermittent fasting” is used. The word “intermittent fasting” refers to a variety of strategies. The 5:2 diet, alternate-day fasting, and time-restricted eating are the three most popular and researched approaches.
Time-restricted eating is the first of these, and it entails consuming all of your daily caloric intake during a single “feeding window” of six to eight hours. For instance, someone following this diet might only eat between midday and six o’clock every day, abstaining from all calorie-dense foods and beverages for the remaining 18 hours. A person following an alternate-day fasting diet eats normally one day and has little or no food the next. Last but not least, the 5:2 diet calls for regular eating on five days a week but fasting on the other two days.
Each of these plans has a wide range of variants. Which of these, if any, is best for patients with Type 2 diabetes is still unknown. The most typical, according to Horne, is probably time-restricted eating, followed by two-day fasting every week. “However, at this time, I would say that no particular plan stands out as the best one.” The “right” strategy is one that a patient will adhere to, he continues. Even if the more rigorous fasting regimens prove to be the most effective, it won’t matter if people can’t maintain it.