In the recent past, intermittent fasting has become popular, mostly for losing weight. But some global studies have shown that it can lead to diabetes remission, perhaps due to weight loss. Just a week ago, a study published in the Journal of Clinical Endocrinology and Metabolism showed how over 44 per cent of people on an intermittent fasting diet for three months achieved Type-2 diabetes remission, discontinued their medication or insulin and maintained it as such for the follow-up period of one year. “While this is calorie-restricted eating and comes in a variety of formats, no particular one has proven best for people with diabetes,” says Dr Anil Bhoraskar, Secretary, Diabetic Association of India (Scientific Section) and Senior Diabetologist at SL Raheja Hospital, Mumbai.
Is intermittent fasting (IF) safe for people with diabetes?
Intermittent fasting is a type of diet that involves limiting your meals to a certain window of time, followed by a fixed period of eating little or nothing. The fasting period can last anywhere between a few hours to multiple days. It may be effective for weight loss, which in turn can lower the risk of diabetes in obese patients. While intermittent fasting is considered safe for non-diabetics, people with diabetes may be more prone to fluctuations in blood sugar levels, including both hypoglycemia, during and after periods of not eating, and hyperglycemia, when eating after a break. Major adjustments in eating patterns could lead to major fluctuations in blood sugar levels, which can be dangerous.
Hypoglycaemia is a condition wherein the blood sugar level can drop too low if an individual takes insulin or medication and suddenly eats in smaller quantities than normal. According to the American Diabetes Association (ADA) this can lead to symptoms such as shakiness, confusion, irritability, rapid heartbeat, sweating, chills, dizziness and sleepiness, blurred vision and nausea. Hyperglycaemia can happen if you eat more than your typical food intake, which may likely occur if you are hungry after a period of fasting. Besides, wild swings in sugar levels can weaken organ systems. Diabetes patients on SGLT2 inhibitor drugs may develop a highly acidic body condition called ketoacidosis. When you lose body fat with intermittent fasting, you could also lose muscle mass and become weaker. Which is why it should be a guarded and well-guided approach, not resorted to on individual whim and fancy.
Can intermittent fasting cause diabetes?
There is no direct evidence to suggest that it does. A 2020 study on rats found that fasting every other day for 12 weeks led to an increase in abdominal fat, damage to pancreas cells and the development of insulin resistance.
While intermittent fasting diets come in a variety of formats, no particular one has proven best for people with diabetes.(1)16:8: People eat all meals within an eight-hour window followed by 16 hours of fasting. Many people fast from 8 pm until noon the next day and keep their eating window between noon and 8 pm
(2) 5:2: This type of intermittent fasting involves eating normally for five days and then consuming fewer than 500 calories per day on the two days of fasting
(3) Alternate day fasting: This form of intermittent fasting involves a full 24-hour period of not eating anything, followed by 24 hours of eating as usual.
Can intermittent fasting reverse diabetes in some patients?
It can reverse diabetes in certain patients who are not on tablets and insulin. It works in early onset cases.
What are the benefits of intermittent fasting?
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Apart from the metabolic effect on belly fat, it also gives a tremendous sense of mental satisfaction and regularity in the lives of individuals who are trying to manage their diabetes and obesity. However, people with irregular lifestyles and eating habits should attempt such eating patterns under strict medical supervision. This is especially true for individuals, who take oral medications or insulin, as they should closely monitor their blood sugar levels during periods of fasting and eating.
In conclusion, although intermittent fasting of any variety is not recommended to all diabetics, please remember that before starting any diet or weight loss plan, it is important to consult your physician.
Why Dr Anil Bhoraskar?
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Dr Bhoraskar is an experienced Mumbai-based diabetologist, practising since the last 32 years. He completed his MD, post-graduation degree from Grant Medical College, Mumbai, in 1980. He has many papers and publications to his name in national and international journals and has participated in numerous symposiums, seminars and conferences held under the auspices of the Diabetic Association of India, International Diabetes Federation (IDF) and Association of Physicians of India. He is the IDF Representative of India and Chairman-Elect for the South-East Asian region of IDF.
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