Intermittent Fasting: Not So Fast
Keeping up with the latest diets has never been easy. Theres always a new crop of them that pop up, and many become all the rage for a while, garnering avid followers and fierce proponents. And when it comes to delivering on results, such as weight loss, most diets work. Whether you can stick with a diet for a given length of time is another story, however.
Diets that are hot right now include the ketogenic, or keto, diet, low carb, the carnivore diet and intermittent fasting. The very word fasting is probably less than appealing, as it pretty much means you dont eat or drink anything for a specified amount of time. Most health-care professionals dont routinely recommend this for health purposes. But intermittent fasting is different. Is it safe to do if you have diabetes? And is it something you should try?
Intermittent Fasting Facilitates Weight Loss
People with diabetes know that they benefit from losing weight. The problem is that diabetes makes weight loss more difficult.
Thatâs not surprising. Insulin is not only a blood sugar-lowering hormone but also a fat-storage hormone. High levels of a fat-storage hormone are a bit counterproductive when it comes to fat loss.
16/8 intermittent fasting, on the other hand, makes weight loss easier because it lowers the levels of the fat-storage hormone insulin .
The Signs Of Diabetes You Should Never Ignore
To get diagnosed you need to see your GP but first you need to spot the key symptoms of the illness, so its important to know what to look out for.
Dr. Mohan Sekeram, who is GP in Merton, London, explained that diabetes is a condition where you may have too much sugar inside your body.
Posting to TikTok, he revealed some of the key signs and said you should always contact your doctor if you have any concerns.
He said: You may find that youre passing a lot more urine than normal. This is because your body is trying to get rid of as much sugar as possible.
As a result you may find yourself more thirsty and drink a lot more fluids.
Dr. Sekeram added that you might find that you also experience blurred vision and that cuts and bruises might take a lot longer to heal.
You may also experience some tingling in your hands and feet, he added.
Along with these symptoms he listed the other key signs as:
- Extreme hunger
- Fatigue
- Irritability
If you notice any of these symptoms, for yourself or for a loved one, then please do contact a health care professional to get further advice.
Its very important for diabetes to be diagnosed as early as possible because it will progressively get worse if left untreated, he added.
They usually also have high levels of adiponectin, which usually counters diabetes and inflammation.
They cited one case study in which three people with diabetes were followed for several months after starting intermittent fasting.
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I Tried Intermittent Fasting For Diabetes And This Is What Happened
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Grant Tinsley, Ph.D., CSCS,*D, CISSN
Medically Reviewed
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Grant Tinsley, Ph.D., CSCS,*D, CISSN
Medically Reviewed
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My experience reinforced that there is no one-size-fits-all approach to diabetes management.
If youâve ever tried to lose weight, especially for health reasons, you have probably come across articles and blog posts touting the benefits of intermittent fasting.
Itâs also known as intermittent energy restriction in dietitian, nutritionist, and health coach circles. Regardless of which term you use, intermittent fasting is a method of voluntarily cycling between fasting and nonfasting time periods.
I started reading about it a few years ago, because I heard it was helpful for those with type 2 diabetes.
Reported benefits include weight loss and a lower risk of future diabetes complications, such as organ damage. The thought process around this is that if you reduce your time periods of high blood sugar, then you reduce the potential for damage caused by long-term unmanaged type 2 diabetes.
In one 2013 study in the British Journal of Nutrition, women with overweight who tried intermittent fasting not only lost weight but improved insulin sensitivity after 3 months.
Ways To Use This Information For Better Health
Adapted from a Harvard Health Blog post by Monique Tello, MD, MPH
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Intermittent Fasting Improves Cholesterol
Diabetes patients are at high risk of cardiovascular disease . Cholesterol levels are seen as a marker to assess the CVD risk. This is the reason why your doctor is worried when your cholesterol is too high.
There are, however, a few misconceptions about cholesterol. First of all, cholesterol alone is not a good marker to assess the CVD risk. Second, even LDL cholesterol, also called the âbadâ cholesterol, is not a good marker.
New research suggests that HDL and triglycerides are better markers. HDL should be high and triglycerides low. 16/8 intermittent fasting increases HDL levels and decreases triglycerides and therefore seems to lower the CVD risk .
What Causes Prediabetes
The exact cause is not yet clear to the scientific community, but itâs often linked to insulin resistance. The hormone insulin is produced by the pancreas and its role is to regulate the absorption of sugar â or glucose to be more accurate â into the cells.
You can think of insulin as the special key that provides glucose with access to the cells where it will eventually be used to make energy. Insulin resistance is when body cells donât respond properly to this hormone, causing blood sugar to spike.
An estimated 9 out of 10 Americans with prediabetes donât know they have it, but it is easy to understand why. As a nearly silent condition, with very few symptoms that are apparent outside of a blood test.
Whatâs more, detecting the condition is fairly easy using a common blood test like the Fasting Plasma Glucose test, an HbA1C test, as well as other insulin resistance tests like a glucose challenge. Someone is diagnosed with prediabetes if their FPG test returns a result of between 100 and 125, or if your A1C results between 5.7% and 6.4%.
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Be Cautious With Carbs
Reversing prediabetes starts with healthy eating, and that often means staying away from certain foods that may result in blood sugar spikes.
The first rule of thumb is to cut down on simple carbs and get rid of sweetened beverages altogether. These easy-release carbs are usually loaded with sugar, plus they usually have no protein, fat, or fiber that can help slow down digestion. As such, they cause your blood sugar to skyrocket and, consequently, increase your chances of getting diabetes.
Refined carbohydrates are another class of foods that spells bad news for anyone on a mission to reverse prediabetes. Examples include:
- Juice
- Processed-wheat pasta
- White bread
They rank very high on the Glycemic Index because they tend to be digested very quickly in your gastrointestinal tract. You should try to stay away from these refined carbohydrates whenever possible in order to to reverse prediabetes. Please note that while whole wheat products are often touted as healthier, they often are high glycemic as well.
Most baked goods, condiments, dressings, and spreads may have added sugar. You should limit intake of your favorite sweet and savory foods, like sweets, desserts, candy, honey, sweet tea, punch, agave, syrups, sweetened yogurt, jellies, jams, and all sorts of pastries.
Foods with âempty caloriesâ like white pasta, crackers, pretzels, and chips should be eliminated from your diet, as well.
The Intermittent Fasting Schedule
There are many ways to do intermittent fasting. Most trials have studied fasting that involves skipping breakfast and eating in the afternoon and evening. This study is the first trial of early time-restricted feeding meant to be in alignment with circadian rhythms in metabolism, write the study authors in their abstract.
They randomized a group of men with prediabetes into an intermittent fasting regimen or a control schedule. The intermittent fasting schedule meant eating between 8 am and 2 pm . The control subjects ate any time during the 12 hour period of 8 am and 8 pm for five weeks and were then crossed over to the intermittent fasting schedule.
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Potential Drawback Of Intermittent Fasting: It May Harm Blood Sugar Control
On the other hand, some experts say that IF carries risks, especially for people who need to keep their blood sugar levels stable. For starters, skipping whole meals can result in poorer blood glucose control, not to mention issues such as fatigue and reduced energyand, thus, an increased risk of injury.
Skipping meals may also cause people to make poor diet choices, which can have the opposite effect on their waistline and blood sugar. If you havent eaten for hours, you may be more inclined to reach for a carb-heavy pastry or plate of pasta, for instance.
Blood sugar management can be a real concern with intermittent fasting for people with type 2 diabetes, Sheth says. Thats why its important to discuss intermittent fasting with your physician, monitor your blood sugar closely, and know that your medications may need to be adjusted as well. Your dietitian and diabetes care and education specialist can help guide and support you through this process.
A plan that severely restricts a persons calories or asks them to skip meals can be hard to stick with long term, too, says Ruth S. Pupo, CDCES, who practices at Adventist Health White Memorial in Los Angeles. While losing weight can be beneficial for people with diabetes, because it increases insulin sensitivity, putting weight back on can have the opposite effect, increasing the risk for diabetes complications.
Are There Foods I Should Avoid In My Prediabetes Diet
As part of your prediabetes diet, we recommend avoiding processed and refined foods as much as possible. These foods tend to be void of nutrients and have a high Glycemic Index, which can cause drastic spikes in your blood sugar. Try to eat these foods and ingredients sparingly:
- Highly Processed and Refined Foods Processed and refined foods are extremely low in fiber and nutrients, which tends to absorb more quickly in the GI tract. These are the types of foods that cause drastic spikes in blood sugar. Replacing these foods with more nutrient-dense options will help prolong the release of glucose into the bloodstream.
- Trans fats
Interested in more details? Read our full blog on foods to avoid for prediabetes
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Should Someone With Diabetes Try Intermittent Fasting Diets
If your heart is set on trying to severely restrict calories in the form of an intermittent fasting plan, then there is nothing to say that you should absolutely not do it, especially if you are among the group of metabolically healthy obese adults who are simply looking into forms of weight loss.
However, if diabetes is a reality of your life and you have to contend with low blood sugar, insulin resistance, checking insulin levels, blood glucose, and overall blood sugar control, then perhaps time-restricted feeding is not right for you.
Take a note of your body mass index, educate yourself on eating disorders, and try to find a path to a healthy lifestyle that doesnt necessarily involve a fasting period that could lead to dramatically lower insulin levels and blood sugars.
People with diabetes should always consult primary care physicians when making any change in dietary regimen. For example, carbohydrate restriction may cause continuous energy restriction which may then interfere with patients medication regimen and therefore negatively affect diabetes care plans.
The road to weight loss is different for all of us, and people with diabetes can still burn fat and promote weight loss in their lives without having to risk further health problems due to early time-restricted feeding routines.
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.
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Intermittent Fasting Is It For You
Intermittent fasting is increasing in popularity as a way to lose weight and assist in managing pre-diabetes, type 2 diabetes and type 1 diabetes. But what do we mean by intermittent fasting? Is it as good as, or better than, normal energy restriction and slow and steady weight loss? And is it safe and suitable for those with diabetes?
Does Intermittent Fasting Help Even Without Weight Loss
Early time-restricted feeding in this study resulted in various benefits.
Participants had improved insulin sensitivity, beta cell responsiveness, and postprandial insulin. In addition, they lowered their blood pressure, oxidative stress, and evening appetite.
The study authors explain they have shown for the first time in humans that this type of intermittent fasting can improve cardiometabolic health and, notably, that intermittent fastings benefits are not just as a result of weight loss.
If youre interested in starting intermittent fasting, talk to your healthcare provider, especially if you take blood sugar-lowering medication such as insulin as careful adjustments may be needed to avoid low blood sugar.
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Can You Participate In Intermittent Fasting
Researchers arent sure which intermittent fasting method is best for you if youre pre-diabetic or diabetic. You should talk with your doctor before beginning an intermittent fasting protocol especially if your diabetes treatment includes medication. Your doctor will help you understand how to check your blood sugar more frequently, and can recommend adjustments to medications as needed.
If your doctor thinks the 16:8 method would be appropriate for you, or maybe even a less strict method, ease into it by fasting for one or two days per week. Be mindful of how you feel and remain aware of the early signs of hypoglycemia, such as lightheadedness. If you do feel hypoglycemic, dont hesitate to break your fasting window your health is a priority.
Use caution when you exercise or participate in activities that can potentially reduce your blood sugar, and be sure to stay hydrated by drinking water regularly throughout the day.
Doctors and scientists recognize the potential use of intermittent fasting as a therapeutic treatment for diabetes. These benefits arise as a secondary benefit of weight loss, and from the unique changes to metabolic pathways that occur as a result of fasting.
After more randomized tests are done, its likely IF will become a standard in diabetes care. Until then, fasting is safe for you under the supervision of your healthcare provider and with increased glucose monitoring.
Drink Plenty Of Water
Water has no calories, no carbs, and no sugar, water is an ideal drink for reversing prediabetes. Itâs also a crucial component of a healthy diet or an effective weight loss program. On a more on-topic note, several studies have suggested that water could play a role in controlling blood sugar levels.
First of all, water is a healthier and more convenient alternative to sugary smoothies, fruit juices, and sweetened beverages. In essence, water can help you cut down on your sugar intake, limit spikes in blood glucose levels, and therefore prevent type 2 diabetes.
In a 2011 study published in the journal Diabetes Care, participants who drank plenty of water were 28% less likely to develop new-onset hyperglycemia, a diabetes-related condition marked by high blood sugar.
Even though more research is still required, scientists noted the hormone vasopressin â whose levels go up when you’re dehydrated â as a potential risk factor for diabetes. By the same token, staying properly hydrated may reduce the chances of increased levels of vasopressin and, as a result, minimize the odds of developing diabetes.
So, how much water is plenty when reversing prediabetes? The right quantity of water you should take every day will greatly depend on your activity level, body size, and where you live. Ideally, men should drink 3.7 liters while women should aim for 2.7 liters per day, according to the National Academies of Sciences, Engineering, and Medicine.
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