Intermittent fasting (IF) has been shown to help diabetic patients achieve many health benefits by reducing their weight, improving insulin sensitivity, and decreasing visceral fat. However, IF can create a few health hazards as well. If you are diabetic, make sure you understand the pros and cons of intermittent fasting before starting.

How is IF Beneficial For Diabetics?

1. Weight loss:

IF reduces calorie intake by limiting eating hours in a day or week, and this in turn helps weight loss ^[1]. Eating hours, calorie intake, and weight loss vary depending on the IF system you select.

2. Increased insulin sensitivity:

Research demonstrates that IF helps improve insulin sensitivity in diabetic patients. A literature review shows that IF could decrease fasting insulin and fasting glucose, as well as reduce insulin resistance ^[2].3

3. Increased fat oxidation:

The body starts utilizing stored fat for energy after the energy from food has been depleted. This leads to increased fat oxidation and reduced visceral fat in the body. Researchers believe that losing visceral fat helps improve insulin sensitivity more than losing overall body fat ^[3].

What Are the Major Hazards of IF For Diabetes?

Two major hazards that IF can cause are:

• Hypoglycemia
• Hyperglycemia

Chances of these conditions increase if IF is not done under strict supervision. Diabetic patients need to measure their blood glucose levels frequently and consistently throughout the IF regimen to maintain and acquire the required levels. There are higher chances of hypoglycemia during the fasting period, especially for patients taking medications. In contrast, there are higher chances of hyperglycemia during eating periods. Additionally, keep in mind that people eat more after many hours of fasting and, from a diabetic’s perspective, often opt for the wrong food choices^[4].

These two conditions may cause nausea, irritability, chills, dizziness, low energy, and neuropathy (nerve damage). As a result,  it is always a good idea to consult with your diabetes specialist before adopting IF as a health regimen.

Is IF Safe For All Diabetic Patients?

Only patients with type II diabetes (non-insulin-dependent) should try intermittent fasting to achieve its health benefits. Patients with Type I diabetes (insulin-dependent) have a higher risk of hypoglycemia (low blood glucose levels) due to their intake of insulin as well as a higher risk of diabetic ketoacidosis ^[5]. Intake of insulin during your fasting periods can lower the glucose levels to dangerous levels. Additionally, women with gestational diabetes should not try IF as it puts the nutrition of both the mother and baby  at risk. Extra calories are required during pregnancy and IF can cause the mother to eat insufficient calories.

Does IF Hinder the Progression of Diabetes?

Patients in the pre-diabetic phase (glucose levels in the blood are higher than a normal individual but not enough to be categorized as diabetic – the HbA1c value generally ranges between 5.7% to 6.4%) can reverse the signs and symptoms of diabetes through IF. Patients can achieve substantial weight loss and betterment in insulin sensitivity, which can slow or stop the progression of diabetes. Even patients with diabetes can remit the signs and symptoms by practicing IF and avoiding diabetes-related health hazards ^[6].

Takeaways For Diabetic Patients Practicing IF

• Don’t start IF before consulting your diabetic specialist (doctor or dietician).
• Monitor your blood glucose levels frequently, especially during the initial duration of the regime.
• Watch your energy levels, especially during fasting hours, to prevent hypoglycemia.
• Keep your diet clean and diabetes-friendly during your eating period.

References:

^[1] Nowosad K, Sujka M. Effect of various types of intermittent fasting (IF) on weight loss and improvement of diabetic parameters in humans. Current nutrition reports. 2021 Jun;10(2):146-54.

^[2] Albosta M, Bakke J. Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians. Clinical diabetes and endocrinology. 2021 Dec;7(1):1-2.

^[3] Ahmed A, Saeed F, Arshad MU, Afzaal M, Imran A, Ali SW, Niaz B, Ahmad A, Imran M. Impact of intermittent fasting on human health: an extended review of metabolic cascades. International Journal of Food Properties. 2018 Jan 1;21(1):2700-13.

^[4] Grajower MM, Horne BD. Clinical management of intermittent fasting in patients with diabetes mellitus. Nutrients. 2019 Apr;11(4):873.

^[5] Fernández-Cardona A, González-Devia D, Mendivil CO. Intermittent fasting as a trigger of ketoacidosis in a patient with stable, long-term type 1 diabetes. Journal of the Endocrine Society. 2020 Oct;4(10):bvaa126.

^[6] Lichtash C, Fung J, Ostoich KC, Ramos M. Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study. BMJ Case Reports CP. 2020 Jul 1;13(7):e234223.