- A new preliminary study indicated that type 2 diabetes might not necessarily be a lifelong, chronic disease if intermittent fasting is implemented.
- Experts are cautiously optimistic that intermittent fasting may be viable for patients with type 2 diabetes.
- Still, experts say that the small sample size used for the research raises the need for caution.
- Discussing possible ways to treat and manage type 2 diabetes with your provider is essential before making any decisions.
Intermittent fasting may put patients into remission for type 2 diabetes, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.
“Type 2 diabetes is not necessarily a permanent, lifelong disease,” Dongbo Liu, PhD, of Hunan Agricultural University in Changsha, China, said in a press release. “Our research shows an intermittent fasting, Chinese Medical Nutrition Therapy (CMNT), can lead to diabetes remission in people with type 2 diabetes.”
Intermittent fasting has become a buzzworthy strategy for weight loss in recent years. It involves eating during specific timeframes and fasting for a certain number of hours each day.
Health experts say data from the new research is “promising”
Danine Fruge, MD, ABFP, the medical director at Pritikin Longevity Center, agrees with Liu that the findings are promising.
“The findings are significant to raise awareness and inspire people,” she says.
Still, experts share it’s crucial to interpret research with a critical eye and discuss findings with a provider who can do the same.
“Reading peer-reviewed articles helps to prevent flawed research by validating the authors and the process,” Emily Campbell, RDN, a registered dietitian and certified diabetes educator with Kidney Nutrition. “However, this does not guarantee that the results will have clinical importance to everyone’s health. As a result, it is important to speak with your doctor, even if you read peer-reviewed research, to ensure that the results are relatable to your health situation before making any changes to keep you safe.”
What causes type 2 diabetes?
Type 2 diabetes affects more than 33 million people in the U.S., according to CDC data. It occurs when the body builds up a resistance to insulin, a hormone produced by the pancreas that allows glucose to enter cells and be used for energy. It typically occurs later in life, around or after the age of 45 years old, but increasingly, children and teens are developing it.
The CDC says other risk factors include:
- being overweight
- previously had gestational diabetes, which occurs in pregnant people who have never had diabetes before
- being physically active for fewer than three days per week
- have a parent or sibling with type 2 diabetes
- are Black, Hispanic or Latinx, Indigenous, or Alaska Native, Pacific Islander, or Asian American
Management typically includes checking blood sugar, developing a diet plan, physical activity, and reducing stress, according to the CDC.
Importantly, type 2 diabetes differs from type 1 diabetes.
Dr. Barbara Keber, FAAFP, the vice chair of family medicine with Northwell Health in New York, points out that type 1 diabetes is an autoimmune reaction. It typically — but not always — arises early in childhood and adolescence and occurs when the body produces very little insulin or none at all.
What the research revealed about intermittent fasting and type 2 diabetes
The study was conducted by a team of researchers in China over a three-month span. There were 36 participants, all of whom had type 2 diabetes, who engaged in intermittent fasting. Some were taking agents to lower their blood sugar and insulin.
What might intermittent fasting look like? It varies.
Keber says a sample plan might include:
- alternate days of fasting with a calorie intake of less than 500 for women and 600 for men
- five days of regular eating patterns with two days per week of fasting as described above
- time-limited eating, such as only eating between 10 a.m. to 5 p.m.
“The idea is to induce what is known as ketosis during the fasting periods, which causes the body to use its own fat breakdown to support regular functions…and, therefore, causes the loss of weight.”
Previous research, such as a 2020 review of 41 articles, indicates that intermittent fasting is a way to lose weight and reduce obesity.
In the new study, the data indicated that nearly 90% of the participants lowered their intake of medication to control their diabetes, including individuals on blood-sugar-lowering agents and insulin.
More than half (55%) of these participants went into remission for diabetes and stopped taking their medication. They maintained the remission for at least one year.
Nearly two-thirds of the participants who went into remission had diabetes for more than six years. Therefore, researchers believe this study runs contrary to the idea that people can only achieve remission if they’ve had the disease for a shorter period of under six years.
In their view, the study indicates that intermittent fasting can help patients lose weight and potentially go into diabetes remission as a result.
Intermittent fasting can carry risks for patients with type 2 diabetes
Fruge says the emerging research is interesting, but it doesn’t guarantee an individual patient will achieve diabetes remission if they try intermittent fasting.
“The study cannot tell us how each individual patient will respond to intermittent calorie restriction, which is precisely why it is important to discuss studies with your personal physician,” Fruge says.
Further, Campbell says intermittent fasting carries risks for patients with type 2 diabetes, such as:
- hypoglycemia or low blood sugars, especially if you are on diabetes medications
- malnutrition if you are not getting adequate nutrition during your eating period
- physiological changes like lightheadedness, low energy, irritability
And she raises questions about whether intermittent fasting is a long-term solution. Keber also wonders how long the remission will last for most patients.
“The study only looked at the individuals at one year after their dietary changes and does not tell us about long-term benefits or harms,” Keber says, adding that the sample size of 36 people is also small.
Finally, Keber points out that the research only covers type 2 diabetes and not type 1 diabetes.
Despite the constructive criticism, Campbell says it’s worth discussing with your provider — and emphasizes it’s important to do so before trying it yourself.
“Intermittent fasting may be a viable option for weight loss and blood sugar control for those with type 2 diabetes,” Campbell says. “However, it is important to speak with your doctor before starting, as there may need to be medication changes, and your diet should continue to be adequate to meet your nutrient needs even during your eating period.”
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