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Can Diabetics Do Intermittent Fasting

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How To Follow The : 2 Diet

Can I Do Keto & Intermittent Fasting If I am a Diabetic on Metformin and Insulin? Dr.Berg

Depending on your outlook, the 5:2 diet may be seen as more or less practical than a continuously reduced calorie diet.

The benefit being that on most days you neednt consume less than the daily recommended calorie limit. However, some people may find that calorie intakes of 500 or 600 calories a day are too low to be practical.

For best results, its recommended to follow basic healthy eating rules, such as having a good intake of vegetables, fruit, and limiting intake of processed foods where possible.

During the fasting days, you will need to rely on very low calorie meals to stay within the daily 500 or 600 calorie counts.

Intermittent Fasting Can Help Weight Loss

IF makes intuitive sense. The food we eat is broken down by enzymes in our gut and eventually ends up as molecules in our bloodstream. Carbohydrates, particularly sugars and refined grains , are quickly broken down into sugar, which our cells use for energy. If our cells dont use it all, we store it in our fat cells as, well, fat. But sugar can only enter our cells with insulin, a hormone made in the pancreas. Insulin brings sugar into the fat cells and keeps it there.

Between meals, as long as we dont snack, our insulin levels will go down and our fat cells can then release their stored sugar, to be used as energy. We lose weight if we let our insulin levels go down. The entire idea of IF is to allow the insulin levels to go down far enough and for long enough that we burn off our fat.

Struggles With Calorie Restriction

Some people with diabetes could minimize their need for diabetes medication by continually restricting their calorie intake, which scientists know reduces body weight and improves metabolic health.

However, the authors of the review note that people can struggle to sustain daily calorie restriction for extended periods.

Some people may find it easier to practice intermittent fasting, which shows promise as a way to improve metabolic risk factors, reduce body fat, and promote weight loss in obesity.

To assess the evidence, the authors searched databases for review articles, clinical trials, and case series related to type 2 diabetes and intermittent fasting published between 1990 and 2020.

They concluded that this type of diet may improve several key features of the disease. The improvements include:

  • reduced body weight
  • lower levels of leptin
  • increased levels of adiponectin

Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician, they write.

For example, a case study followed three people with type 2 diabetes for several months after they started an intermittent fasting diet, which involved three 24-hour fasts per week.

Over the course of the study, all participants had significantly reduced levels of HbA1c, which is a measure of the average amount of glucose in the blood.

Read Also: Can You Have Coffee While Intermittent Fasting

Benefits Of Intermittent Fasting

A few small human studies have shown evidence that intermittent fasting can have health benefits for those with diabetes. These include:

  • Weight loss
  • Lowering insulin requirements

A long-term study, published in the New England Journal of Medicine, revealed that a fasting state can support several benefits including:

  • Lessening inflammation
  • Dehydration
  • Sleepiness during the day
  • Low energy levels
  • A significantly increased risk of low blood sugar
  • High blood sugar resulting from a surge of stored glucose from the liver when low blood sugar levels result from fasting

Its important to note that more research is needed to definitively back up the claims of side effects from intermittent fasting and to confirm the severity of such untoward reactions.

Because of the likeliness of side effects from fasting when a person has diabetes, its important to consult with your healthcare provider before deciding to start any type of fasting diet.

Intermittent Fasting Can Be Hard But Maybe It Doesnt Have To Be

How Intermittent Fasting Can Help Reverse Diabetes

Initial human studies that compared fasting every other day to eating less every day showed that both worked about equally for weight loss, though people struggled with the fasting days. So, its very reasonable to choose a reduced calorie plant-based, Mediterranean-style diet. But research suggests that not all IF approaches are the same, and some IF diets are indeed effective and sustainable, especially when combined with a nutritious plant-based diet.

We have evolved to be in sync with the day/night cycle, i.e., a circadian rhythm. Our metabolism has adapted to daytime food, nighttime sleep. Nighttime eating is well associated with a higher risk of obesity, as well as diabetes.

Based on this, researchers from the University of Alabama conducted a study with a small group of obese men with prediabetes. They compared a form of intermittent fasting called “early time-restricted feeding,” where all meals were fit into an early eight-hour period of the day , or spread out over 12 hours . Both groups maintained their weight but after five weeks, the eight-hours group had dramatically lower insulin levels and significantly improved insulin sensitivity, as well as significantly lower blood pressure. The best part? The eight-hours group also had significantly decreased appetite. They werent starving.

Just changing the timing of meals, by eating earlier in the day and extending the overnight fast, significantly benefited metabolism even in people who didnt lose a single pound.

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Will Intermittent Fasting Slow Metabolism

Caloric restriction has been shown to lead to metabolic slowdown, where your body adjusts the amount of calories it burns to the amount you are taking in. We know this happens to some degree when we are restricting what we eat at every meal, but there is some disagreement as to whether this happens to the same degree with IF.

Some people argue that IF can actually boost metabolism, while others say it may have an even more detrimental effect on metabolism than caloric restriction. But the crux of it is that if IF helps take off fat that has become dangerous to our health, then the benefits likely outweigh the potential slowing of metabolism.

How Intermittent Fasting Works

The primary goal of intermittent fasting for weight loss is to get the insulin levels to decrease to a level where the body will begin to burn stored fat for energy.

Here is how it works. When the food we eat is metabolized , it ends up as molecules in the blood stream. One such molecule is glucose . Normally, when there is more circulating blood glucose than the body can use for energy, the excess is stored as fat for future use. But, for glucose to be utilized by the cells, it requires insulin. Between meals the body doesnt require insulin so insulin levels decline. When insulin levels are low, the fat cells release some of the stored glucose, resulting in weight loss.

Recommended Reading: Does Psa Blood Test Require Fasting

The Positive Effects Of Intermittent Fasting

Intermittent fasting can be a Key part to a healthy lifestyle Paul Ebeling

A review article concludes that there is ample scientific evidence supporting the claims of the positive health effects of intermittent fasting.

The author of the review, neuroscientist Mark Mattson, who adopted intermittent fasting himself approximately 20 yrs ago and has been studying the impact that intermittent fasting has on health for 25 yrs, declared that it can be part of a healthy lifestyle.

According to Mr. Mattson, intermittent fasting diets usually fall into 2 categories: daily time-restricted eating, which limits feeding times to 6-8 hrs a day, and the 5:2 intermittent fasting diet, which limits eating to 1 moderately sized meal 2X a wk.

A collection of studies have demonstrated that cellular health is supported by alternating fasting and eating times, probably by activating metabolic switching, an age-old adjustment to periods of food scarcity. Such a switch happens when sugar-based fuel stores which are rapidly accessible become depleted, and cells start to convert fat into energy metabolically slower.

There is also emerging evidence that obesity and diabetes associated risk factors can be modified with intermittent fasting.

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Should You Consider Intermittent Fasting

Can intermittent fasting reverse diabetes?

If you have type 2 diabetesand especially if you have challenges managing your blood sugar, you require insulin therapy, or are taking numerous type 2 diabetes medicationsit is advised to consult with a health care provider before entering any intermittent fasting program that is not supervised by medical experts. If you follow an intermittent fasting program, its also important that your blood sugar levels are carefully monitored, as you may be able to lower or even stop your insulin therapy or type 2 diabetes medications.

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Drawbacks To Consider Before Starting Intermittent Fasting

Although IF/TRF may carry health benefits and is generally safe for people with diabetes, there are some drawbacks:

  • It is difficult to start a new eating routine! Transitioning from a round-the-clock eating schedule to one with planned feeding and fasting times can be stressful, and it might not align well with your daily life. For example, if you exercise in the morning or are an athlete, it might not be possible to participate on an empty stomach.

  • Any style of fasting will affect your blood glucose levels and insulin requirements. Especially when starting a fasting regimen, you will need to closely monitor these indicators to make sure that your glucose levels stay in range. If you have type 1 diabetes or are dependent on insulin, you should also test your ketone levels consistently to avoid the risk of ketoacidosis .

  • IF/TRF can have side-effects, such as shakiness, hypoglycemia, irritability, hunger, increased heart rate, sweating, chills, and dizziness.

  • Know that IF/TRF can lead to unhealthy eating habits, including disordered eating. If you are concerned that you or someone else with diabetes may be experiencing disordered eating, contact the Diabulimia Helpline or We Are Diabetes the National Eating Disorders Alliance is a resource for anyone with or without diabetes.

Here Are Some Tips For Doing Intermittent Fasting For Diabetes Management

If youre interested in trying intermittent fasting to better manage your diabetes, its important to talk to your doctor first, Dr. Céspedes says. They may have some concerns you havent thought of, and may even need to adjust your medication.

Its also important to think about what youre 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 youll probably be ready to eat as soon as your feeding window starts, its important to plan ahead to make sure you have quality food ready to go once your fasting period is over.

Read Also: How To Start Intermitten Fasting

/5the Problem With Intermittent Fasting

For those taking medicines or insulin to manage their blood sugar level, it is crucial to eat something at regular intervals to balance their sugar level. That’s why they are recommended to space out their mealtimes throughout the day to balance their glucose level. Fasting when suffering from this condition may lead to hypoglycemia , making the person feel tired, anxious, pale, famished and irritated.

In Intermittent fasting, one has to avoid eating for fixed hours and consume all the calories in the remaining hours. The fasting period can be of 10 hours, 16 hours or a day, depending on the type of Intermittent fasting you choose to do.

What An Intermittent Fasting Schedule Looks Like

Intermittent Fasting with Type 1 Diabetes

There are a lot of different ways you can approach fasting, and after doing this for several years on and off, Ive found I can flexibly create my own approach that feels most natural to me.

Here are 3 of the most popular fasting schedules, adapted from Dr. John Berardis guide to intermittent fasting:

  • 24-hour fast: You eat dinner on Thursday , and then you dont eat again until dinner on Friday. This should generally only be performed once per week.
  • 16-hour fast: You eat dinner on Thursday , and then you dont eat again until 1 or 2 p.m. the next day. Its important to note that you should still eat a normal days worth of calories during that 8-hour eating window. If youre trying to lose weight, that amount of calories might only be 1200 to 1600, but you still need to get your calories while following a fasting program.
  • Periodic fast: You suddenly decide to go 24 hours without eating, unrelated to your fasting or eating schedule throughout the rest of week. I like using it when I know Im going to be eating a really heavy meal . Ive also used this when I know Im going to be sitting in a car for a long time on a road-trip, or if I know Im going to be somewhere new with my kids and I really dont want to risk any low or high blood sugars I just want to remove diabetes from the equation altogether so Ill fast as long as I can that day.

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What Are The Downfalls Of Intermittent Fasting For Diabetes

Many clinicians, myself included, have found that intermittent fasting can exacerbate disordered eating patterns in vulnerable individuals. Waiting too long to eat can alter hunger hormones and increase cravings and appetite. For many people this can lead to overeating and sometimes binge eating.

As far as the research goes, some studies have found that IF may increase binge eating in women with bulimia. Others have found that IF may actually help in overweight and obese individuals.

So, the existing data tells us that IF has the potential to be harmful to normal-weight individuals and those with preexisting disordered eating behaviors and diagnosed eating disorders. Women may also be at an increased risk for negative outcomes associated with intermittent fasting.

A few studies have found that long-term intermittent fasting in overweight and obese women resulted in a longer than average menstrual cycle and altered reproductive hormone levels in normal-weight women. More research needs to be done to understand the full impact of IF on women’s menstrual cycles, but this is definitely something to look out for if you’re thinking of trying IF.

Additionally, one study looked at the effects of three weeks of IF in overweight men and women. Results found that men had improved measures of glucose control, but women actually had impaired glucose control.

Should You Try Intermittent Fasting

If all of the above sounds appealing to you, give it a try!

A few things to keep in mind when trying intermittent fasting with type 1 diabetes:

Learn. Study. Experiment. Repeat!

Update: I recorded this video where I talk more about why I do fasted cardio, how I do it, and the benefits. Please let me know what you think in the comments below

If you liked this guide to intermittent fasting with type 1 diabetes, please sign up for our newsletter in the form below. We send out a weekly newsletter with the latest posts and recipes from Diabetes Strong.

Recommended Reading: What To Eat When Not Intermittent Fasting

Can You Fast If You Have Diabetes

Yes in some circumstances, but it depends on how healthy you are.

Ultimately, it is a personal choice whether or not to fast. However, if you do choose to fast, then you must consult your doctor or healthcare team, to make sure that you are able to look after yourself properly. We’ve got lots more information about fasting and how to do it safely.

What Is Intermittent Fasting

Does Intermittent Fasting Cause Diabetes

Intermittent fasting has recently gained popularity as a means of improving body composition and metabolic health . Intermittent fasting refers to eating patterns based around the principle of consuming very little to no calories for time periods ranging from 12h to several days with a regular pattern . There are several different regimens of intermittent fasting. One such regimen is alternate day fasting, in which days of fasting are separated by days of ad libitum food consumption . Another method is periodic fasting, in which individuals fast for 1 or 2days a week . Finally, the most common method is time-restricted feeding, in which food consumption is only allowed during a specified window of time each day, typically with 1620h daily fasts . See Fig. for a visual representation of the most common intermittent fasting regimens.

Fig. 4

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Fasting Affects Blood Sugar Management And Insulin Resistance

What does fasting have to do with insulin? Insulin is the primary hormone our bodies use to regulate blood sugar levels. Maintaining stable blood sugar levels is an important goal for people with diabetes and is often measured by Time in Range, A1C, and fasting glucose levels.

Recently, clinical researchers looked at how IF and TRF affect things like blood sugar management and insulin resistance and found promising results.

  • In a 2021 literature review, eight studies showed that individuals who practiced intermittent fasting had significant reductions in fasting glucose levels . Other important findings included a reduction in A1C levels, weight loss, and an increase in adiponectin .

  • A study of men with prediabetes found that early morning TRF decreased insulin levels , reduced fluctuations in insulin levels, and decreased insulin resistance. This translates to an improvement in insulin levels and insulin sensitivity.

  • A research team from the University of South Australia conducted a pilot study and a larger study to look at the 5:2 IF method in people with type 2 diabetes. Both studies found significant reductions in A1C levels and body weight after 12 weeks.

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