Can “intermittent fasting” solve diabetes?

The topic of Intermittent Fasting (IF) has been one of great interest among my patients in recent years, mostly due to increased media exposure and celebrity endorsements of the method as an effective way to lose weight. As more and more people are quick to jump on IF as a solution it is important to clarify a few things.

First I would like to clarify that IF is not starvation. Starvation occurs due to extreme hunger or lack of food. IF is a controlled cycling between periods of eating and not eating while food is readily available.

I would also like to point out that IF is a practice unique to each individual. For instance, some might fast between breakfast and dinner for a predetermined amount of time while some only eat breakfast and then fast for roughly 24 hours. Another fasting method involves simple decreases in calories – eating normally Monday through Wednesday, for example, then significantly cutting calorie intake on Thursday and Friday.

While fasting is not new – IF has also been practiced by humans for centuries in major religions and more recently as preparation for medical procedures – the use of IF as a verified weight loss method requires more information.

The issue surrounding IF is that, though there have been studies to determine the results of fasting in relation to weight loss, those studies involve a very small sampling of subjects so the overall and long term effects are unknown. That does not mean IF has no benefit.

Of everything I have seen, researched, and tried with my own patients, the use of IF as a treatment for an epidemic affecting more than 500 million people worldwide shows promise. That epidemic is type 2 diabetes and IF, when practiced correctly, could be a viable way to keep its symptoms under control.

Type 2 diabetes is the most common form of diabetes and usually occurs in people who are overweight or obese. The disease causes a condition known as insulin resistance. This means that people with this type of diabetes are able to make insulin but are unable to use that insulin to move glucose (sugar) into their cells where it can create energy. Because of this, blood glucose levels rise. Heightened levels of blood glucose over time can cause damage to the vessels that carry blood to your organs. This increases risk of vision problems, nerve problems, kidney and pancreas failure, and even stroke.

The use of IF to treat type 2 diabetes has recently come into focus and is gaining traction in practice and study. It makes sense that IF could serve as a treatment for this type of diabetes since changes in diet and timing of eating can dramatically impact blood sugar levels. This is where a closer look is needed.

I am a strong believer in the power of eating breakfast because of its ability to kick start metabolism, boost energy, promote heart and brain health, and balance blood sugar levels. As previously stated, IF when practiced correctly, could be a viable way to control the symptoms of type 2 diabetes. Because of the positive effects breakfast has on blood sugar levels I feel that one of the most reasonable IF methods is early time-restricted feeding (eTRF).

eTRF is a form of IF in which you eat a healthy breakfast early in the morning and then proceed to fast for the remainder of the day. This cycle is then repeated for a predetermined amount of time. According to a study released by ScienceDirect, “Intermittent fasting improves cardiometabolic [risk of developing type 2 diabetes] health; however, it is unknown whether these effects are due solely to weight loss.”

In the study researchers wanted to test IF benefits through eTRF outside of weight loss. They did this by placing a group of prediabetic men on an eTRF program. The study found improvement in multiple areas including insulin sensitivity, blood pressure and appetite. Because of these findings it was determined that eTRF improves “some aspects of cardiometabolic health and that IF’s effects are not solely due to weight loss.”

When it comes to weight loss one of the strongest advocates for the use of IF is nephrologist (kidney specialist) Dr. Jason Fung. Fung believes that IF is an, “Underutilized therapeutic option for losing weight” and in turn a viable solution for reversing type 2 diabetes. According to Dr. Fung the medical community “has been treating type 2 diabetes incorrectly,” and that “even if your blood-sugar gets better, you gain weight and your diabetes is only getting worse.”

Though these statements are disputed by some medical professionals, others are in agreement with Fung and have began to take a hard look at IF as a treatment option for their diabetic patients. Fung strongly believes that, “Periods of fasting allow the body to burn off the excess sugar and then the cells become responsive to the insulin once again.”

Dr. Fung has a strong point. When my patients change their diets by cutting their intake of glucose-creating refined carbohydrates naturally their glucose levels drop. If this practice is paired with IF then the body has more time to use the glucose and then turn to fat for energy. This practice could plausibly reverse the effects of type 2 diabetes.

As with any treatment it is important to remember that outcomes will vary from person to person. There are many variables with IF that should be taken into consideration. Are you currently treating your type 2 diabetes with supplemental insulin? Are you able to stick to an IF routine? Answers to questions like these can shed a lot of light on whether IF is right for you.

While IF looks promising I believe that more studies are needed to determine long term outcomes and medical benefits that fasting can provide. If you are thinking about IF for weight loss or treatment of type 2 diabetes please consult you doctor before making any changes. There is one thing we all can agree on – IF is something that should be performed under medical supervision.