Is it possible to cure or even reverse type 2 diabetes with intermittent fasting?

Intermittent fasting is defined as a consistent pattern of eating few or no calories for a certain amount of time, which can range from 12 hours per day to one or more days per week.

Some people follow these diets in the hopes of losing weight, improving their overall health, or a combination of the two.

According to an assessment of the existing evidence, these diets can help persons with type 2 diabetes minimize or perhaps eliminate the need for medication.

More research is needed before doctors can recommend the diets to persons with the disease on a wide scale.

Intermittent fasting has grown in favor in recent years as a strategy to lose weight, improve health, and boost performance.

According to some research, this dietary approach may even lengthen healthy lifespan without the requirement for the tight caloric restriction associated with traditional anti-aging diets.

Intermittent fasting involves eating few or no calories for a period of time ranging from 12 hours to one or more days each week. Periodic fasting is the name for the former strategy, whilst time-restricted feeding is the name for the latter.

According to a recent evaluation of the evidence, this type of diet may be able to safely reduce or perhaps eliminate the requirement for medication in patients with type 2 diabetes.

Before starting such a diet, consumers should seek the advice of a diabetes specialist.

The review was published in Clinical Diabetes and EndocrinologyTrusted Source by Dr. Michael Albosta and Jesse Bakke, Ph.D. of Central Michigan University College of Medicine in Mount Pleasant.

Insulin resistance is a condition in which the body's

Diabetes affects 34.2 million people in the United States, or nearly one out of every ten persons, according to the Centers for Disease Control and Prevention (CDC). It was the country's seventh top cause of death in 2017Trusted Source.

Hyperglycemia is a condition in which people with type 2 diabetes have abnormally high glucose levels in their blood.

Hyperglycemia in type 2 diabetes can be caused by a variety of reasons. Reduced insulin secretion and sensitivity of the body's tissues to the hormone, which regulates blood sugar levels, are two among them. Insulin resistance is the medical term for this diminished sensitivity.

The illness can lead to kidney failure and blindness, among other serious consequences.

The goal of type 2 diabetes treatment is to prevent or delay problems while maintaining a person's quality of life.People with type 2 diabetes should exercise regularly, maintain a healthy weight, and consume a well-balanced diet, according to healthcare professionals. Most people, however, require medication to reduce their blood glucose levels.The majority of these medications elevate insulin levels, which the review's authors claim can have unanticipated negative consequences.

"While this reduces hyperglycemia in these patients, treating an insulin resistance condition by boosting insulin may be counterproductive, resulting in the need for higher doses of medication over time."

The medicines can cause weight gain and insulin resistance in those who take them.

Furthermore, they may have elevated levels of leptin, a hormone that generally suppresses appetite. This could indicate that they are becoming more resistant to this hormone as well.

They also had reduced amounts of a third hormone, adiponectinTrusted Source, which is normally used to combat diabetes and inflammation.

Calorie restriction causes problems

Some persons with diabetes may be able to lessen their reliance on diabetic medication by following a calorie-restricted diet, which has been shown to lower body weight and enhance metabolic health by scientists.

However, the review's authors point out that people may find it difficult to maintain daily calorie restriction for long periods of time.

Intermittent fasting, which has shown promise in improving metabolic risk factors, reducing body fat, and promoting weight reduction in obese persons, may be easier for some people.

The authors searched databases for type 2 diabetes and intermittent fasting review articles, clinical trials, and case series published between 1990 and 2020 to assess the evidence.

They came to the conclusion that this type of diet could help with a number of crucial aspects of the condition. Among the enhancements are:

• body weight reduction

• insulin resistance is lessened

• Adiponectin levels increased when leptin levels were reduced.

"Patients were able to reverse their requirement for insulin therapy following therapeutic intermittent fasting protocols under the supervision of their physician in several investigations," they write.

For example, three persons with type 2 diabetes were tracked for several months after they began an intermittent fasting diet that included three 24-hour fasts every week.

All patients had considerably lower HbA1c levels during the duration of the trial, which is a measure of the average amount of glucose in the blood.

Within one month of starting the diet, all three people had dropped weight and were able to discontinue taking insulin.

They also stated that they found the diet to be tolerable, and that none of them elected to discontinue the diet at any stage.

"They had significantly cured their type 2 diabetes in less than a month," says one of the case study's authors, Dr. Jason Fung, a kidney specialist and proponent of intermittent fasting.

"Even a year later, I believe two of them are off all meds [...]," Dr. Fung says on the Weight Loss Motivation podcast, "so doing amazingly well for an intervention that is actually free, available to everybody, and has been used for thousands of years."

The authors of the review also highlighted a clinical trial in which 137 participants with type 2 diabetes were randomly allocated to either a continuous calorie-restricted diet or an intermittent fasting diet.

The two groups exhibited similar reductions in HbA1c levels after a year. Intermittent fasting participants, on the other hand, lost more weight on average.

How does it work?

Intermittent fasting may reduce body fat and insulin resistance not just by lowering overall calorie intake but also via "metabolic reprogramming," according to the authors of the review.

This reprogramming entails switching from glucose to fatty acids and ketones derived from the breakdown of fat reserves.

Intermittent fasting, they write, may enhance sensitivity to leptin and adiponectin, which improves appetite control and lowers chronic inflammation by lowering body fat.

They conclude, however, that this type of diet may not be suitable for everyone, writing:

"While alternate-day fasting and periodic fasting have been shown to improve metabolic risk factors, patients may find it difficult to give up or severely restrict calories for a whole 24-hour period." We eat three meals a day on average in America, with frequent snacking in between."

They also warn that intermittent diets may pose a risk to one's health.

For example, they recommend that those who take insulin-increasing drugs be continuously monitored by healthcare experts. This is done to avoid hypoglycemia, or dangerously low blood sugar levels, when fasting.

"[Diabetics] should see their physician before initiating an intermittent fasting regimen to ensure proper oversight and titration of the patients' medication regimen during fasting periods," they add.

The evidence's limitations

The authors point up some of the evidence's limitations.

Many randomized controlled trials of intermittent fasting, for example, have excluded diabetics. More trials in persons with this illness are needed, they say.

They also point out that animal studies provide the majority of the evidence for benefits in body composition and metabolic health with intermittent fasting.

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