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August 10th, 2018

Does Intermittent Fasting Help Diabetes?

Intermittent fasting and diabetes

Check out this answer from Consensus:

Intermittent fasting appears to be a promising strategy for weight loss and improving certain metabolic parameters in patients with type 2 diabetes. While it shows similar efficacy to continuous energy-restricted diets in terms of glycemic control, it offers additional benefits in weight reduction and insulin sensitivity. However, the long-term safety and adherence to IF regimens require further investigation. Patients interested in IF should consult their healthcare providers to ensure safe and effective implementation.

Intermittent fasting (IF) has gained popularity as a dietary strategy for weight loss and metabolic health. This synthesis examines the impact of IF on diabetes, particularly type 2 diabetes mellitus (T2DM), based on recent research findings.

Key Insights

  • Weight Loss and Glycemic Control:
    • IF is associated with greater weight loss compared to standard diets in patients with T2DM, but it shows similar effects on glycemic control (HbA1c levels) as continuous energy-restricted diets .
    • Different types of IF, such as alternate day fasting (ADF) and time-restricted feeding (TRF), have shown improvements in diabetic parameters like fasting glucose, fasting insulin, and HOMA-IR index, although the effects on HbA1c are less consistent .
  • Insulin Sensitivity and Beta Cell Function:
    • IF can improve insulin sensitivity and beta cell function, as evidenced by studies on fasting-mimicking diets (FMD) in animal models, which also showed normalization of blood glucose levels and prevention of beta cell loss .
  • Safety and Feasibility:
    • IF is generally considered safe for patients with T2DM when done under medical supervision, with appropriate glucose monitoring and adjustments in medication .
    • There is a need for more long-term studies to confirm the safety and efficacy of IF, especially regarding its potential risks like hypoglycemia in patients on insulin or sulfonylureas .
  • Potential for Diabetes Prevention:
    • IF may help in preventing the onset of T2DM by aiding in weight loss, reducing hepatic steatosis, and improving insulin resistance in individuals at high risk for diabetes.

 

Does intermittent fasting help diabetes?

Dominique Hansen has answered Uncertain

An expert from Hasselt University in Exercise Physiology, Diabetes, Obesity

The number of studies that have examined this are still low in type 2 diabetes.

 

Does intermittent fasting help diabetes?

Sharayah Carter has answered Likely

An expert from University of South Australia in Nutrition, Dietetics

There is limited research in the area of intermittent fasting (IF) and diabetes. Carter et al. (2018), conducted a 12 month IF vs. daily energy restriction (DER) study in 137 obese individuals with type 2 diabetes and reported a similar decrease in average blood glucose (hemoglobin A1c), fasting blood glucose and cholesterol in both groups, with the decrease attributed to similar weight loss (1). Overland et al. (2017), who conducted a small study comparing the effects of IF and DER in 10 individuals with type 1 diabetes likewise reported no difference between groups (2). Therefore, the suggestion that there may be additional metabolic benefits achieved via IF is currently unproven. Any beneficial effects observed are currently linked to weight loss, which is comparable to DER (3-6). But, perhaps the question should be, ‘is IF safe to use for people with diabetes?’ IF is safe for people who have either diet-controlled type 2 diabetes or are using medications not likely to cause hypoglycaemia (this should be confirmed with a healthcare professional). For people using medications likely to cause hypoglycemia, IF can be used safely but only under strict medical supervision, with regular blood glucose monitoring (preferably continuous monitoring) and appropriate medication adjustment (1-2, 7). 

  1.     Carter, S., et al. Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: A randomized noninferiority trial. JAMA Network Open. 2018;1(3):e180756.
  2.     Overland, J., et al. The safety and efficacy of weight loss via intermittent fasting or standard daily energy restriction in adults with type 1 diabetes and overweight or obesity: A pilot study. Obesity Medicine 2018;12:13-17.
  3.   Headland, M., et al. Weight-Loss Outcomes: A Systematic Review and Meta-Analysis of Intermittent Energy Restriction Trials Lasting a Minimum of 6 Months. Nutrients. 2016; 8(6):p.354.
  4.   Seimon RV., et al. Do intermittent diets provide physiological benefits over continuous diets for weight loss? A systematic review of clinical trials. Mol Cell Endocrinol. 2015;418:153-172. 
  5.     Varady, KA. Intermittent versus daily calorie restriction: which diet regimen is more effective for weight loss? Obes Rev. 2001;12 (7):e593-601.
  6.   Rynders, CA., et al. Effectiveness of Intermittent Fasting and Time-Restricted Feeding Compared to Continuous Energy Restriction for Weight Loss. Nutrients. 2019;11(10). 
  7.     Grajower MM, Horne BD. Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus. Nutrients. 2019;11(4):873.