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Fasting With Type 2 Diabetes

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Is Intermittent Fasting Safe For Diabetes

Intermittent Fasting for Type 2 Diabetes (Step by Step) | Jason Fung

Intermittent fasting may present some risks for people with diabetes.

If you use insulin or medications and suddenly eat much less than normal, blood sugar can drop too low. This is called hypoglycemia.

According to the American Diabetes Association , hypoglycemia can lead to symptoms such as:

  • high blood pressure

Before starting any diet or weight loss plan, consider meeting with a member of your diabetes care team, such as a physician or dietitian, to make sure its safe for you.

Some early research on animals shows that intermittent fasting may impact the pancreas and insulin resistance, but more studies are needed to determine its impact on diabetes in humans.

A 2020 study looked at what happened to rats when they fasted every other day for 12 weeks. It found that the rats had an increase in belly fat, damage to pancreas cells that release insulin, and signs of insulin resistance.

Its important to note that the findings may be different if humans took part in the same experiment. More research is needed to determine whether intermittent fasting can increase the risk of diabetes in people.

It may be possible for intermittent fasting to put diabetes into remission for some people, perhaps due to weight loss.

A 2018 case report evaluated three people with type 2 diabetes who used insulin and fasted at least three times a week. Within a month, they no longer needed to use insulin.

Other weight loss strategies may also help reverse diabetes, however.

The Risks Of Intermittent Fasting

Low blood sugar, a.k.a. hypoglycemia, can cause a rapid heart rate, sweating, shakiness, and other symptoms. If severe, it can induce weakness, seizures, or even death. People with Type 2 diabetes are at increased risk for hypoglycemiaespecially if they go long periods without eatingand this was one of the first dangers experts looked at when assessing the safety of intermittent fasting. If you are taking medications that are aimed at reducing the amount of glucose in your blood, together with fasting these can cause potentially fatal hypoglycemia, Horne says. Its not a minor safety risk.

For people who arent 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 diabetesa 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. Its not so much should they or shouldnt they. Its more the degree to which they should be monitored, he says.

Aside from hypoglycemia, a second major concern is dehydration. High blood glucose causes general dehydration in the body, and people with Type 2 diabetes are already at elevated risk. Intermittent fasting may further increase these risks if people are drinking or eating less than they normally would.

The Effects Of Alternate Day Fasting On The Expression Of Nitrotyrosine Protein A Marker Of Oxidative Stress In Small Mesenteric Arteries And Mesenteric Adipose Tissue

Nitrotyrosine protein levels were elevated in both SMA and MAT of Leprdb diabetic mice compared with m Leprdb control mice. ADF reduced SMA nitrotyrosine protein levels in Leprdb diabetic mice without affecting that in the m Leprdb control mice . ADF, however, did not significantly decrease MAT nitrotyrosine protein levels .

Figure 5. ADF reduced nitrotyrosine protein levels in SMA, but not MAT, of Leprdb mice. Nitrotyrosine protein levels were higher in SMA of Leprdb mice. ADF reduced nitrotyrosince protein in SMA of Leprdb mice. n = 4 mice per group. Nitrotyrosine protein levels were higher in MAT of Leprdb mice. ADF did not alter nitrotyrosince protein in MAT of Leprdb mice. n = 6 mice per group. *P< 0.05 vs. m Leprdb control mice, # p< 0.05 vs. Leprdb diabetic mice.

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Can Intermittent Fasting Cause Diabetes

Although IF can help with type 1 and 2 diabetes in many cases, thereâs also a concern that the diet might cause diabetes in prediabetic or otherwise healthy people. Continuous fasting can potentially damage insulin, increasing the dieterâs risk of developing diabetes.

As type 2 has become an epidemic over the past couple of years, this could be detrimental. The University of Sao Paulo in Brazil conducted an animal study evaluating the potential risks of intermittent fasting on rats over three months. Although weight loss occurred, long-term IF may damage the pancreas and affect insulin function in healthy individuals.

Although immediate results can be beneficial for the prevention and treatment of type 1 and 2 due to the reduction in body mass index, there is still a concern for the long-term effects that researchers have not studied as thoroughly.

Its important to note that this is a single study conducted on rats and not humans. We need more research to understand if there is any link between IF and diabetes in humans and whether long-term intermittent fasting is safe for those with diabetes. Discuss IF with your primary care doctor or diabetic team before starting the diet to ensure itâs safe for you to participate.

Functional Assessment Of Small Mesenteric Arteries

How Intermittent Fasting Can Help Reverse Diabetes

Mesenteric arteries with internal diameter of 200â250 μm were cut into 2 mm long rings and mounted in a Myograph 610M . The passive tension-internal circumference was determined by stretching to achieve an internal circumference equivalent to 60â70% of that of the blood vessel under a transmural pressure of 100 mmHg. Vessels were maintained in Physiological Saline Solution bubbled with 95% O2â5% CO2 at 37°C for the remainder of the experiment. PSS contained 118.99 mM NaCl, 4.69 mM KCl, 1.18 mM KH2PO4, 1.17 mM MgSO4â¢7H2O, 2.50 mM CaCl2â¢2H2O, 14.9 mM NaHCO3, 5.5 mM D-Glucose, and 0.03 mM EDTA. After an equilibration period of 45 min, vessels were precontracted with 1 μmol/L phenylephrine . A cumulative doseâresponse curve was obtained by adding acetylcholine and sodium nitroprusside . Relaxation at each concentration was measured and expressed as the percentage of force generated in response to 1 μmol/L PE. NO availability was evaluated by ACh concentration-response curve repeated after incubation with the NO synthase inhibitor N-Nitro-L-arginine methyl ester . PE-induced vasoconstriction was evaluated by cumulative addition of PE . The contraction induced by PE was normalized to the maximal force of contraction induced by 120 mM of KCl .

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Try Changing Your Exercise Timing

Your body only has two major storage pools for glucose: the muscles and the liver. Late evening exercise â particularly if it is long in duration or high-intensity â can significantly deplete those stores. Combined with inadequate re-fueling, some people can experience hypoglycemia the following morning.

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Causes Of Impaired Fasting Glycaemia

IFG develops if your body becomes unable to control glucose levels. Your body may be unable to use insulin properly or produce less insulin. There are a number of factors that may make you more likely to develop IFG. If youre black or South Asian and over 25, or if youre white and over 40, and you have one or more of the following risk factors, then you may be at risk of IFG:

  • one of your parents, brother or sister has type 2 diabetes
  • youre overweight or you carry extra weight around your middle rather than your hips and thighs
  • you have high blood pressure or you have had a heart attack or stroke
  • you have polycystic ovary syndrome and you are overweight
  • you have had diabetes during pregnancy
  • you have severe mental health problems

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Symptoms Of High Fasting Glucose Levels

High fasting blood sugar levels suggest that the body cannot lower blood sugar levels. The reason for this may be insulin resistance or inadequate insulin production, or in some cases, both. Recognising the signs and symptoms of hyperglycemia can help you manage your diabetes. Some patients with diabetes have symptoms of elevated blood sugar right away. In contrast, others go undetected for years due to mild or ambiguous symptoms. Early symptoms include:

  • Frequent urination

Diabetes And The Hemoglobin A1c Test

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The hemoglobin A1c test , is an important diabetes blood test used to determine how well your diabetes is being controlled. This diabetes test provides an average of your blood sugar control over a six- to 12-week period and is used in conjunction with home blood sugar monitoring to make adjustments in your diabetes medicines. The HbA1c level can also be used to diagnose diabetes if a value of equal to or greater than 6.5% is found.

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What Are The Benefits Of Intermittent Fasting For Diabetes

When done safely, intermittent fasting may provide some benefits for people with diabetes. If the eating plan leads to weight loss, people may be able to reduce the amount of diabetes medication they take.

Some people have been able to stop using insulin after fasting intermittently for a month or so, according to the small study on three people mentioned earlier.

More research is needed to determine if intermittent fasting can help most people with diabetes stop using insulin.

Other potential benefits include:

  • reduced appetite
  • increased fat oxidation

More research is needed to determine the long-term benefits of intermittent fasting on glucose control and diabetes complications, according to the ADA.

What Is Intermittent Fasting

Intermittent fasting is a type of diet in which people cycle between periods of eating and fasting. It does not specify the foods that are allowed during the eating window.

The most common type of fasting is known as the 16:8 method, which involves fasting for 16 hours and reducing the eating window to just 8 hours. For example, a person can have dinner at approximately 7 p.m., skip breakfast the day after, and eat lunch at around 11 a.m.

Other forms involve fasting for 2 days per week, 24-hour fasting once or twice each week, and fasting every other day.

Researchers used intermittent fasting as a method to reduce the symptoms of type 2 diabetes in a new observational study conducted in Canada and published in the journal BMJ Case Reports.

The study included three men, aged 4067, who were taking both drugs and daily doses of insulin to manage the disease. They all had high blood pressure and high cholesterol.

The use of a therapeutic fasting regimen for treatment of is virtually unheard of, the authors of the study write.

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Is Intermittent Fasting Safe For People With Type 1 Diabetes

Many people with type 1 diabetes have found that IF and TRF can help reduce morning blood sugar fluctuations and improve their energy. An observational study on people with type 1 diabetes who participated in various forms of IF/TRF found that these eating schedules can be safe as long as the individual works with their healthcare professional to reduce their usual insulin dose while fasting, and they must monitor their glucose levels carefully to avoid hypoglycemia. Fasting will also increase your ketone levels, so it is important to test your blood ketone levels if you have type 1 diabetes to avoid the risk of ketoacidosis. Remember that people with type 1 diabetes absolutely require insulin to avoid DKA, so insulin dose adjustment to avoid low glucose levels must be done cautiously.

For anyone with diabetes, before trying any type of fasting you should talk to your healthcare professional. For people who take sulfonylureas or insulin, it is important to closely monitor blood sugar levels, especially when you first start a fasting regimen, as dose reductions may be necessary to avoid hypoglycemia. Never stop taking a medication or change its dosage without consulting your healthcare professional first.

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Animal Models And Treatment

Treating Type 2 diabetes with intermittent fasting. Dr Fung and his ...

The procedures followed were in accordance with approved guidelines set by the Animal Care Committee at the University of Missouri . Mice were purchased from the Jackson Laboratory . Homozygote type 2 diabetic mice are wildtype for Dock7 and homozygous for Leprdb . The heterozygote control mice from the colony are heterozygous for Dock7m and heterozygous for Leprdb. Because of the sterility of Leprdb homozygotes, the misty mutation has been incorporated into stocks for maintenance of the diabetes mutation . The repulsion double heterozygote facilitates the identification of heterozygotes for breeding . Mice that are homozygous for Dock7m and wildtype for Lepr from the colony are discarded . The Leprdb mice demonstrate morbid obesity, chronic hyperglycemia, and are polyphagic, polydipsic, and polyuric . Heterozygotes control mice are normal in body weight, blood glucose, and plasma insulin .

Mice were maintained on a standard rodent diet. Twelve to sixteen week-old, male, 20â35 g m Leprdb, and 40â60 g Leprdb mice were used in this study. Mice were fed ad libitum on alternate days and then moved to a separate cage without food for 24 h to prevent food from being stored in the bedding. Mice were maintained on a 12-hour light/dark cycle and between 18â23°C according to animal protocols and NIH guidelines. To determine the effects of recombinant resistin treatment, Leprdb mice were treated with murine recombinant resistin as previously described .

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What Is Type 2 Diabetes

Type 2 diabetes occurs when the body no longer produces enough insulin, or has difficulty using the insulin it produces, causing sugar to build up in the blood.

Over time, this damages blood vessels and nerves and can result in severe complications including: blindness, heart disease, stroke, kidney failure, nerve damage, amputation, and erectile dysfunction.

Adopting a healthier lifestyle can help prevent or control type 2 diabetes, and can significantly reduce your risk of heart disease, and stroke. It can also contribute to your overall well-being and quality of life.

Did You Know?

Nine out of ten Canadians with diabetes have type 2 diabetes. Seniors represent almost 45 per cent of the total number of people with the disease, and this number is expected to rise as Canadas population continues to age.

Healthy Eating During Intermittent Fasting

For the best results with intermittent fasting, here are some healthy eating tips:

  • Avoid or significantly limit your intake of simple carbohydrates, sugars, and refined grains, like cereal, rice, and baked goods.
  • Focus on eating vegetables, low-sugar fruits, lean protein sources, and healthy fat.
  • Dont snack between meals.
  • Dont snack or eat at night.

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How Does Fasting Affect My Metabolism

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Sugars and fats serve as our bodys main sources of energy. After a meal, sugars are used for energy first. They are broken down and delivered to the bloodstream, while fats are stored for energy later. When we restrict eating, our bodies run out of carbohydrates to use for energy and instead breakdown stored fats, converting them into ketones.

Ketones are our body’s alternative to using glucose for energy, and fasting or carbohydrate restriction can make this alternative available for energy use. The change from using sugars to using ketones is known as metabolic switching, a process that scientists believe produces many of the health benefits attributed to IF beyond weight loss. Intermittent fasting and time-restricted feeding allow us to control this process and cause metabolic switching in our own bodies.

However, the excess production of ketones can lead to a dangerous condition known as diabetic ketoacidosis or DKA, especially if you have type 1 diabetes. Because of this risk, you should talk to your healthcare team before starting a diet that includes fasting so that your health can be monitored effectively and your medication doses can be adjusted. If you have type 1 diabetes, you will have to regularly test your ketone levels to avoid the risk of DKA. This risk is especially high if insulin doses are reduced excessively to avoid hypoglycemia while fasting.

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