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Is intermittent fasting good for diabetics: The request could not be satisfied


What Do The Experts Say?

Intermittent fasting is a type of eating plan that involves a limited time period when caloric intake is restricted. This can vary from fasting (not eating at all) all day long for several days per week, to simply limiting the number of calories that are ingested during the fasting period. There are specific intermittent fasting diets, such as those that restrict food intake after a specific time of day (usually during the evening hours), to those that rotate between eating normally and restricting a certain number of calories during the day on fasting days. More dramatic fasting diets involve restricting all foods for a complete 24-hour time span, or longer.

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History of Diabetes and Intermittent Fasting

Fasting has been around for some time, particularly if you consider the historical role of fasting as part of many types of spiritual rituals. More recently, intermittent fasting has been used as part of a healthy diet for weight loss, as part of “detoxifying” the body, and more. But there has been much controversy surrounding the topic of fasting for those with diabetes.

Today, there is a growing body of evidence indicating that specific types of intermittent fasting diets may be beneficial for people with diabetes. In addition, scientists are beginning to speculate that when a person fasts may be just as important as the diet itself.

Glucose Metabolism

To fully understand the benefits of intermittent fasting and diabetes, it’s important to know a little about the physiology of the body when it comes to the action of glucose and insulin.

Insulin is a hormone that enables glucose (sugar)—derived from the food we eat—to enter the cells of muscles, stored fat, and the liver, where it is used for energy. When blood glucose levels rise, insulin is released from the pancreas; the insulin lowers blood sugar levels as it carries the glucose into the cell, keeping blood sugar levels within normal levels.

Insulin Resistance

When the cells of the muscles, fat, and liver are unable to respond normally to insulin, glucose begins to accumulate in the blood because it is not able to properly enter the cells. This is called insulin resistance. When insulin resistance begins, the pancreas will attempt to make more insulin, to overcome the condition (in an effort to transport the blood sugar into the cells). The blood sugar level will stay within normal range until the pancreas is no longer able to make enough insulin to combat the weakness of the cells.


When blood glucose levels are higher than normal, but not high enough to warrant a diagnosis of diabetes, it’s called prediabetes. Prediabetes usually occurs in those with some level of insulin resistance. Prediabetes also occurs in those whose pancreas doesn’t make enough insulin to keep the blood sugar within the normal range. Over time, prediabetes often progresses into type 2 diabetes.

How Intermittent Fasting Works

The primary goal of intermittent fasting for weight loss is to get the insulin levels to decrease to a level where the body will begin to burn stored fat for energy.

Here is how it works. When the food we eat is metabolized (broken down to be used as energy in the body), it ends up as molecules in the blood stream. One such molecule is glucose (which comes from the breakdown of carbohydrates). Normally, when there is more circulating blood glucose than the body can use for energy, the excess is stored as fat for future use. But, for glucose to be utilized by the cells, it requires insulin. Between meals the body doesn’t require insulin (unless a person is snacking) so insulin levels decline. When insulin levels are low, the fat cells release some of the stored glucose, resulting in weight loss. 

Benefits of Intermittent Fasting

A few small human studies have shown evidence that intermittent fasting can have health benefits for those with diabetes. These include:

  • Weight loss
  • Lowering insulin requirements

A long-term study, published in the New England Journal of Medicine, revealed that a fasting state can support several benefits including:

  • Lessening inflammation
  • Lowering insulin levels
  • Improving a wide range of illnesses (including asthma, arthritis, and more).
  • Detoxifying the body
  • Helping the body rid itself of damaged cells (which may lower the risk of cancer)

Other reported benefits from fasting include:

  • Lowering cholesterol levels (specifically triglycerides and LDL cholesterol)
  • Reducing blood pressure

According to a 2019 study published in the journal Nutrients, “Long-term benefits of fasting, including cardiovascular risk reduction, remain to be fully studied and elucidated, especially in humans.”

Side Effects

Side effects of intermittent fasting may include:

  • Bad breath (which often results from low carbohydrate diets)
  • Difficulty concentrating
  • Excessive hunger
  • Irritability
  • Insomnia
  • Dehydration
  • Sleepiness during the day
  • Low energy levels (may impact a person’s ability to exercise, which is important for healthy weight maintenance in people with diabetes)
  • A significantly increased risk of low blood sugar (hypoglycemia)
  • High blood sugar (hyperglycemia) resulting from a surge of stored glucose from the liver when low blood sugar levels result from fasting

It’s important to note that more research is needed to definitively back up the claims of side effects from intermittent fasting and to confirm the severity of such untoward reactions.

Because of the likeliness of side effects (such as hyperglycemia) from fasting when a person has diabetes, it’s important to consult with your healthcare provider before deciding to start any type of fasting diet.

Types of Intermittent Fasting Diets for Diabetes

There are several intermittent fasting diets that have had some preliminary research as to the effectiveness and safety of the diet for people with diabetes, including:

The 5:2 Intermittent Fasting Diet

Thee 5:2 intermittent fasting (IF) diet (commonly referred to as the 5:2 diet) is one type of popular fasting diets, introduced in Dr. Jason Fung’s best-selling book “The Obesity Code” in 2016. The 5:2 diet involves five days of eating the recommended daily caloric intake and two non-consecutive days of eating a reduced-calorie diet. On fasting days, food is not eliminated altogether, rather, the number of calories is reduced.

If you have diabetes and want to try the 5:2 diet, speak to your healthcare provider or diabetic team and get a recommendation for a daily caloric intake guideline for fasting and non-fasting days.

Studies on the 5:2 Diet

Studies have shown that the 5:2 diet may help reduce insulin resistance and promote weight loss in people with type 2 diabetes or prediabetes.

The first long-term study of the 5:2 diet, published in 2018, by the Journal of the American Medical Association (JAMA), discovered that intermittent fasting could be effective for those with diabetes who have trouble sticking to a long-term, daily diet regime. The study observed 137 people with type 2 diabetes; half of the study participants followed the 5:2 diet and the other half adhered to a daily calorie-restricted diet (comprised of 1200 to 1500 calories per day). The group that fasted for two non-consecutive days per week—consumed 500 to 600 calories on the fasting days and ate normally on the other five days of the week.

The study concluded that those who followed the 5:2 diet were just as likely to control their blood sugar levels as those who followed the ongoing restricted-calorie diet. “It [the 5:2 diet] may be superior to continuous energy restriction for weight reduction,” wrote the study authors.

Safety of the 5:2 Diet for People With Diabetes

While some experts claim that the safety of the 5:2 diet for people with diabetes has not yet been fully established, a long-term study published in 2018 reports that “fasting is safe for those with diet-controlled type 2 diabetes.”

The study authors conclude that those who take insulin or oral (by mouth) medications to reduce blood glucose levels (oral hypoglycemics) such as glyburide or metformin, require very close monitoring and possibly adjustments to medication doses, accordingly. This is because fasting is likely to cause hypoglycemia in those taking oral hypoglycemics or insulin.

Note, although this study result was very positive regarding the safety of fasting for those with diabetes, It’s important to consult with your healthcare provider before fasting, or starting any other type of diet.

Early Time-Restricted Feeding Diet (eTRF)

Another type of intermittent fasting diet that has been studied in people with diabetes is called the “early time-restricted feeding (eTRF)” diet. Following this fasting meal plan means that a person will fit all their meals into a specific period of time each day.

The eTRF diet plan may be an 8-hour, 10-hour, or even a 6-hour plan. On the 8-hour plan, if a person begins eating at 7:00 a.m., the last meal or snack for the day would be at 3:00 p.m. An example of the 12-hour early time-restricted feeding plan would be when a person eats the first meal of the day at 7:00 a.m. and the last meal or snack would be planned for no later than 7:00 p.m.

How the eRFD Diet Works

The eTRF diet is thought to align with a person’s circadian rhythm in metabolism, thus, improving weight loss. Circadian rhythm refers to the body’s biological clock that controls many mechanisms, including cellular metabolism.

Changing the eating pattern to a period earlier in the day—thereby extending the overnight fast—was found to greatly benefit metabolism, but why? According to a study published in the New England Journal of Medicine, fasting triggers a few important cellular functions, such as lowering blood sugar and improving metabolism.

Benefits of the eTRF

Benefits thought to be derived from the eTRF diet include:

  • Decreasing appetite
  • Facilitating weight loss
  • Increasing fat loss via oxidation (burning of fat) 
  • Lowering blood pressure

Study on the eTRF Diet for Diabetes
In a 2018 study, the 8-hour early time-restricted feeding diet was compared with the 12-hour diet. The study discovered that the 8-hour group had dramatically lower insulin levels; both groups (the 8- and 12-hour group) maintained their weight (neither losing or gaining weight) and achieved significantly lower insulin levels, as well as lower blood pressure.

Tips for Intermittent Fasting When You Have Diabetes

According to Diabetes UK, there are some general tips that are important to follow if you have diabetes and you plan to start an intermittent fasting diet. These include:

  • Consult with your healthcare provider or diabetes team regarding whether intermittent fasting is recommended for you; if so, follow the team’s advice on medications for diabetes (regarding time or dosage changes) to ensure blood glucose level control.
  • Maintain a balanced diet during the fasting periods as well as the non-fasting periods, including foods from all of the food groups.
    Do not eat excessively during the non-calorie restricted periods.
  • Include foods that are more slowly absorbed, such as those considered lower on the glycemic index scale, just before you fast (these foods are typically high in fiber and are digested slowly).
  • Be sure to eat foods that fill you up and maintain your blood sugar during the fast, such as fruits, vegetables, and fresh salads.
  • When you break the fast (for example, in the morning after a 12-hour fasting period) limit the amount of fatty or sugary foods and try grilling or baking foods instead of frying.
  • Drink plenty of fluids during the fast to avoid dehydration (avoid sugary drinks).
  • Test your blood glucose levels often to check for either hypoglycemia or hyperglycemia.
  • If you experience symptoms of hypoglycemia, it’s vital to break the fast immediately, and use your normal course of action (such as taking glucose tablets, followed by a snack). Consult with your healthcare provider before continuing the fast.
  • Those with type 1 diabetes should observe for signs of hyperglycemia as a result of fasting (including extreme thirst and frequent urination as well as severe fatigue. Contact your healthcare provider right away if you experience these symptoms and blood sugar levels remain high.

The safety of fasting for those with type 1 diabetes has not been fully established. You should never fast if you have type 1 diabetes without first consulting with your healthcare provider.

A Word From Verywell

According to Harvard Health, there are some general recommendations on how to utilize recent medical science breakthroughs about intermittent fasting for those with type 2 diabetes (or prediabetes), these include:

  1. Avoiding snacking to allow the body to burn fat between meals.
  2. Avoiding refined (white) sugar and grains (such as white flour), opt for whole grains instead.
  3. Eating fruits, vegetables, beans, lentils, and lean proteins as well as good fats (from unsaturated, non-trans-fat sources) and whole grains (such as quinoa, oats, and brown rice).
  4. Avoid eating any type of snacks or meal before bedtime.
  5. Consider a simple form of intermittent fasting (after consulting with your healthcare provider) limiting food intake to between the hours of 7 a.m. and 3 p.m. or 10:00 a.m. to 6:00 p.m.

Diabetes and intermittent fasting: Benefits and risks

Intermittent fasting is a type of eating pattern that involves periods of voluntary fasting. There are various methods, which vary in terms of the permitted eating hours.

Many people believe that intermittent fasting can aid weight loss and offer other health benefits.

This article looks at whether this eating pattern might be beneficial for people living with type 2 diabetes.

Intermittent fasting (IF) is an eating regimen that cycles between periods of eating and periods of voluntary fasting or very low calorie intake. Researchers believe that IF leads to a metabolic switch from the use of glucose as the primary energy source to the use of fat.

IF also has a positive effect on the circadian rhythms of both gut biology and the release of insulin and growth hormone. In these ways, it improves energy metabolism and weight regulation.

There are several methods of intermittent fasting, which involve fasting for different periods:

Time-restricted feeding

This type of IF involves eating during only a certain number of hours each day. A popular plan is the 16:8 method, which requires a person to fast for 16 hours and eat during an 8-hour window.

Alternate day fasting

People following this pattern alternate between a “fast day,” when they consume no or minimal calories (up to 500), and a feasting day, when they can eat as much as they want.

Periodic fasting

This type of fasting involves no or minimal calorie intake for 24-hour periods. Examples are the 5:2 diet and Eat Stop Eat.

With the 5:2 method, a person eats normally on 5 days of the week and then eats about 500 calories during each of the 2 fasting days, which should not be consecutive.

People adhering to the Eat Stop Eat regimen have to refrain from food and calorie-containing drinks for an entire 24-hour period once or twice a week. They should then eat “responsibly” on the other days of the week, rather than treating them as feast days.

The majority of IF research has involved animals rather than human participants. The evidence to support health improvements in people is promising, but many of the clinical studies to date have been relatively short-term interventions over a period of months.

A 2018 review article showed that nearly all IF studies resulted in some degree of weight loss, ranging from 2.5% to 9.9%, and associated fat mass loss. However, there is little research to prove that IF is superior to other diets and eating patterns in promoting weight loss.

The use of an IF diet may also have a beneficial effect on blood pressure. In one study, researchers observed 1,422 people for 1 year while they followed a fasting program. The participants experienced a reduction in both systolic and diastolic blood pressure.

In another study, which involved adult males, researchers found that IF provided metabolic and cardiovascular benefits, such as a decrease in total cholesterol and low-density lipoprotein (LDL) cholesterol.

Scientists know that insulin resistance improves with calorie restriction. After a period of fasting, insulin sensitivity increases, and insulin levels decrease. These changes result in improved blood sugar levels both during fasting and shortly after eating.

IF can have various health benefits for people with diabetes. These include:

  • promoting weight loss
  • improving insulin sensitivity, leading to lower insulin requirements
  • normalizing fasting blood glucose levels
  • reducing hemoglobin A1c levels

Many people with type 2 diabetes also have metabolic syndrome, hypertension, or hyperlipidemia. IF may improve these metabolic parameters.

IF can produce various side effects, such as:

  • dizziness
  • nausea
  • insomnia
  • syncope
  • falls
  • migraine headaches
  • weakness that limits daily activities
  • excessive hunger pangs

Having a chronic disease such as diabetes may increase a person’s risk of experiencing many of these adverse events.

There is also a risk of hypoglycemia in people with type 2 diabetes, especially those who are taking insulin or medications such as sulfonylureas. This risk is lower with other diabetes medications, but it still exists.

Dehydration is a risk as well. Even though a person can consume calorie-free liquids on “fasting days,” unless they drink additional fluids, dehydration can occur.

Dehydration can then lead to hypotension. On fasting days, people may need to reduce or completely stop some medications. These include diuretics, antihypertensives, and diabetes medications that can lead to dehydration, such as SGLT-2 inhibitors.

However, it is essential never to stop taking a medication or change the dosage without speaking with a doctor first.

In one small case series, three men were able to reverse their insulin resistance due to IF, allowing them to maintain control of their blood sugar levels even after ceasing insulin therapy. In addition, they experienced weight loss, a reduction in waist circumference, and a decrease in hemoglobin A1c levels.

However, as relapse of diabetes is a possibility, it is more accurate to say that these individuals are in remission.

In another study, the Diabetes Remission Clinical Trial (DiRECT), the researchers randomized the participants to one of two groups: weight management or pharmacological therapy. They found that 46% of the participants in the weight management group achieved diabetes remission.

Still, the research to date remains limited, and further studies are necessary.

IF may worsen symptoms in people with hard-to-control blood sugar levels and those with brittle diabetes.

There is minimal research on the effects of IF in certain populations, such as people who are pregnant or lactating.

People at higher risk of developing side effects such as hypoglycemia, dehydration, and hypotension should also avoid IF. These individuals include older adults, those with immunodeficiencies, and those with a history of traumatic brain injury or dementia.

Deliberately engaging in fasting can also exacerbate the challenges that people with eating disorders face.

A person with diabetes should consult their doctor before starting IF to ensure that it is safe for them. A person will also need their doctor’s guidance on adjusting the dosages and timing of their medications to reduce the risk of hypoglycemia.

Individuals trying IF should check their blood sugars more frequently — ideally, every 2–4 hours — especially when first starting out.

People with hypoglycemia should break their fast immediately and treat their low blood sugar with 15 grams of carbohydrates in the form of glucose tablets or gels. They should consult with a doctor before restarting the fast.

It is also important to drink additional fluids during the fasting period to reduce the risk of dehydration and hypotension. A doctor may recommend stopping or reducing the dose of some diabetes medications, diuretics, and antihypertensives.

People should maintain a balanced diet on nonfasting days and avoid processed, fatty, and sugary foods. Doing so will mean that they do not reverse the positive effects of the fasting days.

There are a few diet takeaways from the science of IF. Insulin sensitivity changes with a circadian rhythm, decreasing throughout the day and into the night. Therefore, meals that a person consumes at night are associated with higher glucose and insulin levels.

Liming the hours of eating to a time earlier in the day — for example, selecting an 8-hour window between 7 a.m. and 3 p.m. or even 10 a.m. and 6 p.m. — is effective in boosting metabolism and aiding in weight loss.

People should also try to avoid eating and snacking shortly before going to bed. Not snacking between meals will facilitate the metabolic switch from the use of glucose for energy to the use of fat.

A balanced diet is also important, so people should avoid sugars and processed carbohydrates, focusing instead on eating fruits, vegetables, whole grains, lean meat, and healthy fats.

Perhaps the most important factor, though, is that people choose an eating plan that they can sustain in the long term.

Dr. Kelly N. Wood, M.D., is an internal medicine physician who is board certified in Endocrinology, Diabetes, and Metabolism. She earned her medical degree from The University of the West Indies in Barbados before relocating to the United States in 2006. Dr. Kelly is currently in clinical practice in Atlanta, GA.

Intermittent Fasting and Type 2 Diabetes

WRITTEN BY: Sarah Colvert


What is Fasting?

Fasting is the act of not eating for significant lengths of time and began when food was scarce. However, fasting is also done spiritual, religious and health reasons. 

What is an intermittent fast?

We all fast. We fast while we sleep and break the fast with breakfast, hence the name, but going even longer periods without food can have a lot of positive outcomes. Traditional fasting is usually understood as going a full day or more without food, while intermittent fasting (IF) can be achieved in many different ways. Some people on an intermittent fast skip just breakfast and then don’t eat anything after 7 or 8pm. Some people go an entire 24 hour period, twice a week on non-consecutive days, without food and then eat slightly larger portions the other five days. Some people skip dinner. Some greatly restrict calories for two separate days a week. There is no one way to fast intermittently. As long as we are deliberately not eating for a set period of time, we are fasting in some capacity.

The benefits of intermittent fasting

Fasting has long been known to provide health benefits like improving cholesterol and blood pressure; helping with weight loss, anxiety and depression; preventing neurodegenerative diseases like Alzheimer’s and Parkinson’s and expanding “synaptic plasticity (a biological marker of learning and memory).”[1]  So not only does fasting help us physically but mentally as well.

One of the main benefits of intermittent fasting for those living with Type 2 is that it decreases visceral fat. When we fast, we take in less calories. Even when we eat normally, or slightly larger portions on our non-fasting days or during or non-fasting times, our overall caloric load is diminished, as are our glucose stores. When glucose is no longer available for energy, our body then uses ketones and our stored fat to compensate for the deficit. Eating calorically restricted (CR) diets or carb restricted diets can accomplish the same outcome, but many people find it easier to restrict food entirely for short periods of time than to eat less or avoid beloved foods at every single sitting. Intermittent fasting has also been shown to maintain lean mass and reduce fat mass more than traditional caloric restriction, meaning that muscle mass isn’t lost at the same rate with IF as it is with CR.

Will intermittent fasting slow metabolism?

Caloric restriction has been shown to lead to metabolic slowdown, where your body adjusts the amount of calories it burns to the amount you are taking in. We know this happens to some degree when we are restricting what we eat at every meal, but there is some disagreement as to whether this happens to the same degree with IF.

Some people argue that IF can actually boost metabolism, while others say it may have an even more detrimental effect on metabolism than caloric restriction. But the crux of it is that if IF helps take off fat that has become dangerous to our health, then the benefits likely outweigh the potential slowing of metabolism.

Possible risks

The good news is that IF may very well be an easier way for many people living with Type 2 to get their weight back to a healthy level. The bad news is that as soon as IF was stopped, glucose levels reverted. Intermittent fasting, like all diets, only works for as long as it is maintained.

What we eat can become a risk when living with Type 2 diabetes. This is the case with any diet we choose and intermittent fasting is no different. “The biggest downside to intermittent fasting for people with type 2 is the danger of hypoglycemia or low blood sugar. For this reason, it is recommended that type 2s who wish to follow these diets consult with a nutritionist or their healthcare practitioner, both to carefully monitor their sugars and to adjust medications if hypoglycemia becomes an issue.” [2] Many people report an adjustment period to this new way of eating. Initially one might experience headaches or light headedness during the fasting period. The body quickly adjusts, however,  and if IF is undertaken deliberately and with the guidance of a doctor, insulin can be lowered and perhaps even cut out entirely.

Should you try it?

There is no one-size-fits-all model of food consumption. We each have to shop around and try out various methods of eating before we settle on one that helps us keep a healthy weight and is sustainable in the long term. For those living with Type 2 diabetes, intermittent fasting may very well provide us with these outcomes. 

Related Content:

Want to learn more about diet and nutrition for Type 2 diabetes? Check out all of our resources here!


[1] https://law.stanford.edu/2015/01/09/lawandbiosciences-2015-01-09-intermittent-fasting-try-this-at-home-for-brain-health/

[2] https://www.ontrackdiabetes.com/live-well/eat-well/intermittent-fasting-diabetes-safe-eating-plan-people-type-2

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

A literature review was performed for articles related to the impact of intermittent fasting on type 2 diabetes mellitus. We used PubMed, Google Scholar, and Ovid MEDLINE to search for published articles, including randomized controlled trials, clinical trials, case reports, and case series between the years of 1990 and 2020. Searches through the references of retrieved articles was also performed. Finally, the websites of professional organizations such as the American Diabetes Association and European Association for the Study of Diabetes were searched for specific guidelines and recommendations. The following keywords were used: “intermittent fasting”, “type 2 diabetes mellitus”, “diabetes”, “fasting”, “obesity”, “hormones”, “insulin”, “leptin”, “adiponectin”, “insulin resistance”. Inclusion criteria consisted of published articles, articles that were available in English, and trials/reports with human subjects. Trials were included if the study design involved one of the three most commonly reported intermittent fasting regimens: alternate day fasting, periodic fasting, or time-restricted feeding. Finally, studies were included if the outcome measures included measurement for fasting glucose, HbA1C, fasting insulin, leptin, or adiponectin both in patients with and without a history of diabetes. Exclusion criteria consisted of duplicates, abstracts, non-English articles, articles that did not include human subjects, those that did not report outcome measures for any of the previously described variables, and works that were unpublished or unrelated to the topic of interest. Our initial search returned 6852 studies. Two reviewers independently reviewed abstracts to determine whether studies met our inclusion criteria. Studies that met criteria were then further reviewed to determine whether they would be included in our review. After careful review, a total of 17 articles were ultimately chosen and are available for review in Tables 1 and 2.

Table 1 Clinical Trials of Fasting Regimens in Patients with and without DiabetesTable 2 Case series/reports investigating intermittent fasting in patients with type 2 diabetes

What is intermittent fasting?

Intermittent fasting has recently gained popularity as a means of improving body composition and metabolic health [28, 29]. Intermittent fasting refers to eating patterns based around the principle of consuming very little to no calories for time periods ranging from 12 h to several days with a regular pattern [28]. There are several different regimens of intermittent fasting. One such regimen is alternate day fasting, in which days of fasting are separated by days of ad libitum food consumption [29]. Another method is periodic fasting, in which individuals fast for 1 or 2 days a week (also referred to as 5:2 or 6:1 fasting) [29]. Finally, the most common method is time-restricted feeding, in which food consumption is only allowed during a specified window of time each day, typically with 16–20 h daily fasts [29]. See Fig. 4 for a visual representation of the most common intermittent fasting regimens.

Fig. 4

Intermittent Fasting Regimens

Intermittent fasting, weight loss, and appetite control

Obesity is known to be a major risk factor for the development of type 2 DM. There are a number of mechanisms believed to contribute to the development of insulin-resistance in obese patients. These include, but are not limited to, systemic chronic inflammation and ectopic lipid deposition [7, 9, 30, 31]. Visceral adipose tissue is known to function as both a paracrine and endocrine organ through the secretion of adipokines [10]. These adipokines are either proinflammatory leading to chronic low-level inflammation, such as leptin, or anti-inflammatory such as adiponectin [10]. Leptin is known to play a role in the regulation of body weight through signaling to the hypothalamus and other brain regions to suppress food intake and increase energy expenditure [9]. The inflammatory effects of leptin are likely due to its role in the production of IL-6, which induces the synthesis of C-reactive protein in the liver as well as upregulation of the pro-inflammatory cytokine TNF-alpha [10]. Interestingly, patients with higher levels of BMI and insulin resistance were found to have increased leptin levels, possibly signifying that patients with obesity and insulin resistance are developing leptin resistance as well [10]. On the contrary, adiponectin is known to have antidiabetic and anti-inflammatory effects. Adiponectin acts on various receptors that results in an increase in skeletal muscle and hepatic fatty acid oxidation, reduced hepatic gluconeogenesis, and increased glucose uptake [10]. It also exerts anti-inflammatory effects through direct action on inflammatory cells, action of NF-kB, and interactions with TNF-alpha [10]. Adiponectin levels decrease with accumulation of visceral fat [10]. López-Jaramillo et al. performed a review with the intention of determining levels of leptin and adiponectin in patients with metabolic syndrome. They found that in patients with the metabolic syndrome, which includes obesity and insulin resistance, an imbalance in levels of leptin and adiponectin appeared to play a role in metabolic alteration that increased the risk of type 2 diabetes [10]. Interestingly, several studies have demonstrated that intermittent fasting, even in the absence of fat loss, has resulted in a reduction of leptin levels and an increase of adiponectin, which results in improvements of insulin resistance [32].

It has long been known that restricting calories can reduce body weight and increase metabolic health [33]. A study by Larson-Meyer et al. [34] showed that 25% calorie reduction either via diet alone or diet in conjunction with exercise led to improvements in insulin sensitivity and reduction in β-cell sensitivity in overweight, glucose-tolerant individuals. However, several obesity trials have demonstrated that humans have significant difficulty sustaining daily calorie restriction for extended periods of time [28]. On the other hand, intermittent fasting has higher compliance and has shown promise in the improvement of metabolic risk factors, body composition, and weight loss in obese individuals [28, 35, 36]. It has been shown that these beneficial effects are due in part to the shift during fasting from the utilization of glucose to fatty acids and ketones as the body’s preferred fuel source [28]. During this transition the body begins to switch from the synthesis and storage of lipids to mobilization of fat in the form of ketone bodies and free fatty acids [28]. This transition of fuel source, or metabolic reprogramming, has been highlighted as a potential mechanism for many of the beneficial effects of intermittent fasting. Lastly, intermittent fasting has been shown to reduce adiposity, particularly visceral fat and truncal fat, largely due to mild energy deficits [12, 17]. It is through this reduction in adiposity that patients may experience improvements in their leptin/adiponectin levels and sensitivity, leading to improved appetite control and lower levels of chronic inflammation thus improving several risk factors for type 2 diabetes.

Intermittent fasting and insulin sensitivity

Insulin plays a significant role in glucose homeostasis due to its influence in promoting the storage and utilization of glucose. However, the effects of insulin are not limited to glucose homeostasis. Insulin also plays a role in the stimulation of DNA synthesis, RNA synthesis, cell growth and differentiation, amino acid influx, protein synthesis, inhibition of protein degradation, and most importantly, the stimulation of lipogenesis and inhibition of lipolysis [8].

It is the development of insulin resistance, which is defined as the necessity of higher circulating insulin levels in order to produce a glucose lowering response, that is thought to be responsible for the development of type 2 diabetes [7]. In order to promote regulation of glucose homeostasis, insulin works primarily on receptors in skeletal muscle, liver, and white adipose tissue [7]. In short, there are several proposed mechanisms regarding the development of insulin resistance. One of the more prominent theories describes the association of increased adiposity and the subsequent chronic inflammation that leads to the development of insulin resistance in tissues [7].

Intermittent fasting, as described previously, may reduce adiposity and subsequently insulin resistance via reduction of caloric intake as well as due to metabolic reprogramming. In addition, energy/nutrient depletion (such as that achieved through reduced caloric intake) has been shown to promote healthier aging and reduction in chronic disease through increased activation of AMP activated protein kinase (AMPK) [37]. AMPK responds to both to increased AMP/ADP:ATP ratios as well as to endocrine signals of hunger and satiety [37]. The role of AMPK at a biochemical level is outside of the scope of this review, however activation of AMPK through a low energy state has been shown to initiate physiologic responses that promote healthy aging [37]. Increased levels of insulin, whether through increased energy intake or insulin resistance, leads to the activation of downstream mediators that ultimately inhibit AMPK. The role of AMPK in improved insulin sensitivity is most evident via the positive effects of the commonly prescribed biguanide, metformin. Metformin is known to promote the activation of AMPK, and has been shown to be very effective in the treatment of type 2 diabetes as well as in the mitigation of a number of chronic disease states [37]. In theory, decreased energy intake, such as that is achieved through intermittent fasting, will lead to prolonged decreased levels of insulin production and increased levels of AMPK, which likely plays a role in the improvements in insulin sensitivity and glucose homeostasis.

Intermittent fasting as a treatment for type 2 diabetes?

Several studies have shown promise for the use of intermittent fasting protocols as a potential treatment for diabetes. Tables 1 and 2 illustrate the findings of several recent studies regarding intermittent fasting and its effect on measures including body weight, fasting glucose, fasting insulin, adiponectin, and leptin. The inclusion/exclusion criteria can be found in the supplementary file S1. In a systematic review and meta-analysis by Cho et al. [32] that included studies evaluating patients both with and without pre-diabetes (diabetic patients were excluded), it was found that of 8 studies comparing the effects of an intermittent fasting diet to a control group, BMI decreased by 0.75 kg/m2 over periods ranging from 4 to 24 weeks. Furthermore, of 8 studies comparing intermittent fasting to a control group in the evaluation of glycemic control, it was found that the intermittent fasting group had significant reductions in fasting glucose levels (− 4.16 mg/dL; p = 0.003). Lastly, when comparing leptin and adiponectin levels between the intermittent fasting subjects and the control subjects in all studies, the reviewers found increased adiponectin levels (1008.87 ng/mL; p = 0.023) and decreased leptin (− 0.51 ng/mL; p < 0.001) [32]. A case series by Furmli et al. [26] followed three patients with type 2 diabetes over several months after beginning an intermittent fasting regimen consisting of three 24 h fasts per week. Over the course of the study, all patients had significant reductions in HbA1C, weight loss, and all of the patients were able to stop their insulin therapy within 1 month [26]. Interestingly, the three patients in this case series all reported tolerating fasting very well, and no patient stopped the intervention at any point out of choice [26]. This suggests that intermittent fasting may not only be successful as a non-medicinal treatment option for patients with type 2 diabetes, but supports the notion that this intervention is tolerable as well. Carter et al. [19] performed a clinical trial in which 137 adults with type 2 diabetes were divided into two groups, one intermittent energy restriction group (500–600 kcal/day for 2 days per week and normal diet every other day) and a continuous energy restriction group (1200–1500 kcal/day). After 12 months of intervention, the two groups showed similar reductions in HbA1C levels and greater reductions in weight in the intermittent energy restriction group. Finally, a similar clinical trial by Gabel et al. [16] compared an alternate day fasting regimen (25% of energy needs on fasting days, 125% of energy needs on non-fasting days) to continuous energy restriction (75% of energy needs daily) and a control group of obese, non-diabetic patients. Over an intervention period of 12 months, there were similar reductions in body weight, BMI, and fat mass between the alternate day fasting and continuous energy restriction groups, however there were significant reductions in fasting insulin levels (− 44%; p < 0.05) and homeostatic model assessment of insulin resistance (HOMA-IR) levels (− 53%; p < 0.05) in the alternate day fasting group [16]. HOMA-IR is a marker used to measure levels of insulin resistance.

Prescribing intermittent fasting in practice: recommendations

While alternate day fasting and periodic fasting have demonstrated efficacy in improving metabolic risk factors, it may be difficult to convince patients to give up or severely restrict calories for an entire 24 h period. In America, we often eat 3 meals per day in addition to frequent snacking. Furthermore, in American culture most social engagements involve food. Asking patients to eliminate these experiences from their day to day lives may become burdensome, and thus hinder patient compliance. Finally, patients switching to an intermittent fasting regimen may initially experience symptoms such as hunger and irritability, although these symptoms often dissipate within the first 30 days [38]. Therefore, it would be more appropriate to gradually introduce intermittent fasting in the form of time restricted feeding. For example, clinicians may first recommend that patients restrict their intake to a daily 12 h period, typically an overnight fast (for example, 7 pm to 7 am). As patients become more comfortable with this pattern of eating, the feeding window can be restricted further (16 h fast followed by an 8 h feed or 20 h fast followed by a 4 h feed). This allows the patient some daily flexibility in choosing when to consume calories, thus increasing the likelihood of compliance. Lastly, patients who have become adapted to time restricted feeding may choose to switch to alternate day or periodic fasting with the supervision and guidance of a registered dietician. See Fig. 5 for a detailed example of an intermittent fasting prescription.

Fig. 5

Example of Intermittent Fasting Prescription

Prescribing intermittent fasting in practice: considerations

When considering the use of fasting in patients with diabetes, a number of points should be weighed. First, it is important to discuss potential safety risks associated with fasting. Patients taking insulin or sulfonylurea medications should be closely monitored by their healthcare provider in order to prevent hypoglycemic events [39]. Because studies are demonstrating a decreased need for insulin in patients who follow intermittent fasting protocols, blood glucose levels and medication titration should be observed closely by the physician. Physicians should help patients make appropriate adjustments to their medications, especially on days of fasting. Physicians may choose to have patients keep daily blood sugar and weight logs and send them weekly or biweekly via electronic message in order to assist providers in medication titration over time. Of note, while the goal of adapting this pattern of eating is to reduce or eliminate the need for medications, including insulin, there are situations in which insulin may be necessary, such as severe hyperglycemia. Failure to do so may result in significant consequences, such as the development of hyperosmolar hyperglycemic syndrome. Additional concerns, although unlikely, include vitamin and mineral deficiencies and protein malnutrition [39]. Patients should be educated regarding the importance of consuming nutrient-rich meals and adequate protein intake during feeding periods. Furthermore, it may be important to consider vitamin or mineral supplementation depending on the patient’s dietary practices and the desired length of a fasting regimen. Patients should also be counseled on the need for adequate hydration during periods of fasting, as they will be required to replace fluids that might normally be consumed through food in addition to regular daily requirements. As many physicians may not be trained extensively in nutritional sciences, and further, may not have time to follow daily with patients to ensure appropriate nutritional intake, consultation with a registered dietitian is highly recommended. Lastly, it is important to consider populations in whom fasting may not be appropriate. These include pregnant/lactating women, adults of advanced age, individuals with immunodeficiencies, individuals with hypoglycemic events, and patients who suffer from eating disorders [39].

Limitations and future research

This review is not a systematic review and as such lacks the power to summarize all trails with statistical significance. Having said that, we highlighted the research that has been done in humans and presented evidence that intermittent fasting improves insulin sensitivity, likely through a combination of weight-loss and “metabolic reprogramming”. There is a significant amount of research that has been done on the effects of intermittent fasting in regards to improvements in body composition and metabolic health, however a majority of the data to date has come from animal studies, which were not included in this review. Although there are a number of case reports showing significant improvements in diabetic patients’ glucose control, many of the randomized controlled trials fail to include patients with diabetes. This is an area where further research is needed, as the current trials (and case reports) included in this review that have been done on diabetic patients have shown promise in improving metabolic health with nearly no adverse effects. Most patients doing some form of intermittent fasting experience mild energy deficits and weight-loss, that may not be appropriate for all patients. As such, there needs to be more research into delineating the metabolic improvements of intermittent fasting from weight-loss.

Intermittent dieting has more negatives than positives for weight loss.

With Caroline Apovian, MD, FACP, FACN; Scott Isaacs, MD, FACP, FACE; and, Angela Fitch, MD, FACP

Eat all that you want one day, cut way back the next. This so-called intermittent fasting diet seems to be trending. It may sound like a great way to lower your hemoglobin A1c as the pounds melt off. But is it a good idea?

A new study from New Zealand suggests it might be, while three US doctors who reviewed the findings for EndocrineWeb urge caution, saying there are much better ways to achieve a healthy weight.

The New Zealand researchers found the risk of low blood sugar (hypoglycemia) was increased during the fasting days, as expected, but that the two intermittent fasting plans they tested still managed to produce weight loss and a drop in A1c levels, which is used to assess your risk for diabetes;1 the study is published in Diabetic Medicine.

However, three endocrinology experts who reviewed and commented on the study for EndocrineWeb say other approaches are less hazardous and just as, or more effective in producing a healthy weight loss.

Evaluating the Research on Intermittent Fasting  

Researchers from Wellington Hospital and the University of Otago in New Zealand defined intermittent fasting a bit differently than we do here in the US. Participants could eat whatever they wanted five days a week and then they were instructed to fast for the next two days.1 They had to do this for 12 weeks. In this study, the ”fast” was actually a very low-calorie diet. Men could eat about 600 calories on a “fast” day and women were limited to 500 calories.

At the start, 41 participants who had been living with type 2 diabetes (T2D) for years were randomly assigned to this 5:2 plan, as it is sometimes called. About half of them were instructed to fast for two days in a row during the week; the others were instructed to fast on non-consecutive days.

In the consecutive fasting group, the average age was 62 years and their diabetes diagnosis had been made 13 years ago, on average. In the non-consecutive group, the average age was 58 years, and their diagnosis had been made 9 years earlier.1

The men and women were on a variety of medications, including insulin, sulfonylureas, metformin, and oral hypoglycemic agents.1 The researchers made adjustments to their medications in response to lower blood sugar levels on the fasting days, to avoid worrisome hypoglycemic episodes. The main study aim was to look at low blood sugar events and to monitor the amount of weight loss, A1c levels, and other parameters.1

Implementing the Intermittent Fasting Study 

In all, 15 participants experienced low blood sugar events, for a total of 53 such incidents. The rates of low blood sugar were no differences between the consecutive and non-consecutive groups, but the chance of having low blood sugar was doubled on fasting days than on non-fasting.

Both groups lost weight. At the study start, the group that fasted on non-consecutive days weighed, on average, 242 pounds. By the end of the 12-week study, they had lost on average of 8 pounds. Those in the consecutive fasting group weighed, on average, 239 pounds at the study start, and by the end, they had lost nearly 7 pounds on average, which isn’t statistically significant meaning both groups had similar results.

The level of A1cs declined from 8.2 to 7.5 in the non-consecutive group and from 8.4 to 7.8 in the consecutive fasting days group; also not significantly different.

The final answer on the worth of this approach is still up for debate, the researchers write, “Our study protocol could be adopted for the longer-term studies that will be required to assess the tolerability and sustained efficacy of an intermittent fast.”Unfortunately, they didn’t respond to our questions about how the groups differed and whether any of the participants were willing to stay with the diet long-term.

Intermittent Restricted Calorie Dieting Not Encouraged

While the study demonstrates that the following a very low-calorie diet can be safe for those with type 2 diabetes, at least for 3 months, it is ”not very effective,” says Scott Isaacs, MD, FACP, FACE, an endocrinologist and adjunct instructor of medicine at Emory University School of Medicine, in Atlanta.

“The study showed minimal weight loss over the 12-week period of about 6 to 7 pounds, which is less than the typical weight loss on a standard low-calorie diet,” Dr. Isaacs says. His advice: “Focus on a healthy low-calorie meal plan instead. Clearly following a low-calorie meal plan every day is superior to being on a very low-calorie diet for two days out of the week.”

Angela Fitch, MD, FACP, associate professor of internal medicine and pediatrics at the University of Cincinnati College of Medicine/UC Health, says that while intermittent fasting can be an option, patients who choose this approach must work closely with their doctors to figure out how best to lower their hypoglycemic medications on fasting days.

Overall, however, Dr. Fitch says, “the most consistent way to lose weight and keep it off when you have type 2 diabetes is limiting the carbohydrates in your diet.” Eating less than 150 grams of starchy carbs a day improves blood sugar levels and helps to promote weight loss for most people with T2D, she says. Eating less than 20-50g is even better, but harder to maintain long-term, she says.

The quality of those carbs is crucial, she says. She advises eating carbohydrates with higher fiber content. Choose cauliflower, for instance, not white rice.

Despite the findings that the intermittent fasters lost some weight loss and lowered their A1c levels, the study did find a higher risk of hypoglycemia on the fasting days, points out Caroline Apovian, MD, FACP, FACN, professor of medicine and pediatrics at the Boston University School of Medicine and director, Center for Nutrition and Weight Management, Boston Medical Center.  

“The reason is people on insulin and sulfonylureas really cannot safely do intermittent fasting is because of the risk of hypoglycemia,” she tells EndocrineWeb.

With any of my patients who choose to follow a low-calorie diet, Dr. Apovian warns them that they will need to see her often to monitor their gluocose levels and to adjust their medications, and they will need to check their blood sugars 3 times a day to avoid the risk of hypoglyemia.

“My guess is, people who try this [intermittent fasting] long-term are going to end up gaining weight,” Dr. Apovian says. ”They need something more consistent.”

None of the researchers or physicians interviewed have any financial conflicts.

Last updated on 01/23/2019

Best Diet for Weight Loss, Your Choice: Low Carb vs Low Fat

Is Intermittent Fasting Safe for People With Diabetes?

When the now 46-year-old Mary Roberts from Lockhart, Texas, was diagnosed with type 2 diabetes in 2008, her doctor immediately put her on Metformin (glucophage), a drug to help stabilize blood sugar. “When I got the diagnosis, I guess I wasn’t surprised,” says Roberts, explaining that not only was she overweight but her mom had been on insulin for type 2 diabetes.

Not wanting to be on medication herself for her entire life, Roberts set out on a path to control the diabetes through diet, but a few years of nutrition classes proved unsuccessful in lowering her blood sugar level. It was after her doctor suggested insulin on top of the high dose of Metformin that Roberts switched gears. “I really wanted to find a way to get healthy,” she says.

She found the solution in changing her approach to eating — just not the way she expected. Intermittent fasting (IF) combined with the popular ketogenic diet, which emphasizes dramatically reducing carbohydrate intake, helped her lose weight and lower her A1C. “I feel amazing,” Roberts says.

What Is Intermittent Fasting and How Is It Done?

Although IF has become more popular in recent years, the diet plan isn’t new. In fact, many religions (including Christianity, Judaism, and Islam) have followers who practice fasting of some variety throughout the year. Fasting is often required for blood tests, medical procedures, or surgery. The reason IF has gained so much attention recently is likely due to the release of new diet books plugging the plans and celebrity endorsements. “I think that it has gained popularity because anytime a person drastically cuts calories from their diet, they’re going to lose weight. And we’re so results driven that by seeing that happen we think, This is a great solution,” says Despina Hyde Gandhi, RD, CDE, a dietitian at NYU Langone’s Weight Management Program and the president of the Greater New York Dietetic Association.

There are different ways to do IF, including skipping meals and eating only during a certain time period, as well as restricting calories on certain days of the week and eating normally on other days.

Roberts decided to fast by eating two meals a day, but she never follows a strict schedule. “I eat when I’m hungry,” she says.

Within a few months, Roberts’ blood glucose level went from over 200 milligrams per deciliter (mg/dL) to around 130 mg/dL, and within eight months, it was within a normal range. Her blood glucose level now is always in the 80s and 90s, and her A1C, a two- to three-month average reading of blood sugar, is 4.8, which is also normal. After 22 months, she lost 106 pounds and has since kept it off. “Sometimes I pinch myself [because] I can’t believe I did this. I turned it around,” she says.

The Potential Benefits of Intermittent Fasting for Diabetes

In previous years, dietitians and scientists thought of IF as a negative practice, so there isn’t a wealth of high-quality clinical research on how it may affect people with diabetes, says Jason Fung, MD, a nephrologist in Toronto and the co-author of The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting. But attitudes have begun to change, and some preliminary studies suggest the approach may have benefits, including for people with diabetes.

For example, an early study published in August 2017 in the journal Autophagy found that IF helped preserve beta cells in mice that were manipulated to have obesity-induced diabetes. The combination of beta cell loss and insulin resistance lead to the high blood sugar that marks type 2 diabetes, according to an article published in March 2013 in Frontiers in Endocrinology.

That study was only done in rodents, which doesn’t necessarily mean the same benefits would be seen in humans — nor does it prove that the diet would be safe for people with diabetes. But other research offers clues: One very small observational study, published in April 2017 in the World Journal of Diabetes, suggests short-term daily IF may help improve fasting glucose, weight, and the postmeal blood sugar level in people with type 2 diabetes. Although the study involved just 10 participants, and it was not a randomized controlled trial — the golden standard for research — the findings may hold truth based on what we already know about weight loss. “There’s no denying that anytime you cut calories from your diet, you’re going to see the scale drop,” Gandhi says. That potential aspect of IF can lead to improvements in insulin sensitivity, too, says Michael Mosley, MD, a science journalist and the author of The FastDietFurther research needs to be conducted to see if IF is truly safe for the larger group of people with type 2 diabetes.

While research on IF for diabetes prevention is also in its early stages, one study published in May 2011 in the International Journal of Obesity found that women who followed an IF diet two days per week and those who followed a more traditional consistent calorie reduction seven days per week lost weight. Those in the two-day group saw the greatest weight loss, yet they had only a modest reduction in fasting insulin, a measure of the insulin level over time, and insulin resistance.

Why Intermittent Fasting May Harm Blood Sugar Control

Nevertheless, experts say that IF carries risks, especially when you have diabetes and need to keep blood sugar stable.

For starters, skipping whole meals can actually result in poorer blood glucose control, not to mention issues like fatigue, low energy during workouts (and thus an increased risk of injury), and medication imbalances. It may also lead to worse diet choices, having the opposite impact on your waistline and blood sugar. People who restrict calories may be more inclined to reach for carb-heavy fare, for instance. “Then their blood sugar is going to go very high and going to be erratic throughout the day,” Gandhi says.

Plus, severely restricting calories or skipping meals can be a hard plan to stick with. “The problem with fasting is it may be more difficult to maintain in the long term,” says Ruth S. Pupo, RDN, CDE, who practices at White Memorial Medical Center in Los Angeles. While losing weight can be beneficial for people with diabetes, as it increases insulin sensitivity, putting weight back on can have the opposite effect, thereby increasing the risk for diabetes complications.

Furthermore, certain people, like pregnant and breast-feeding moms, should avoid IF, as should those with an underlying disease or medical condition, Pupo says. “Anytime you have a higher demand for more nutrition, you don’t want to do a fast,” she says, explaining that both pregnant and breast-feeding moms require extra calories for themselves and their babies, and fasting can cause them to run out of glucose and burn fat, tissue, and muscle. What’s more, if a pregnant mom overproduces ketones (substances that are produced when the body uses fat for fuel), the effect can be harmful to the fetus.  

Likewise, for someone with an overactive thyroid, IF can lead to what’s called a “thyroid storm,” which causes an increase in temperature, a rapid heart rate, and possibly even cardiac arrest because of the added stress, Pupo says.

Another risk of IF for people with diabetes is hypoglycemia, or low blood sugar. According to a study published in September 2016 in the journal BMJ Global Health, of 150 people with diabetes who fasted regularly, 10 percent experienced hypoglycemia. People who are on certain diabetes medications, like sulfonylureas and insulin in particular, may be at an increased risk of this complication, which can be life-threatening.

Most important, because of the dangers of blood sugar fluctuation that IF may cause, Gandhi personally advises against the diet plan for people with type 2 diabetes. “It’s not great for diabetes because we don’t want to have those dips, those highs and lows in blood sugar. The goal with diabetes is to maintain a steady and stable blood sugar throughout the day,” Gandhi says.

People with diabetes also run the risk of diabetic ketoacidosis, which is a complication of diabetes that occurs when the body can’t produce enough insulin. Insulin brings glucose into the cells, but when the body doesn’t have enough insulin because carbohydrates aren’t accessible during the fasting periods, the body overproduces ketones. “The ketones from burning fat too quickly have built up in their system, and that could damage the kidneys and go to the brain and cause brain swelling,” Pupo says. Diabetic ketoacidosis may even lead to a diabetic coma or death.

For anyone, regardless of whether they have diabetes, cutting out meals and restricting entire food groups can furthermore cause nutritional deficiencies. Without enough nutrition, particularly protein, there’s also a risk for muscle mass loss. “When you really deprive the body of nutrients, your body not only breaks down fat but muscle as well. And our heart is a muscle,” Pupo says.

Steps to Take Before You Try the Popular Diet Plan

Talk to your doctor. Before starting an IF plan, talk to your doctor to come up with a safe approach and management plan for you, as well as to adjust any of your medication doses. Those people on insulin should be particularly careful: If you’re on it and restrict eating, you may be at a greater risk of low blood sugar, which can lead to life-threatening symptoms, such as dizziness, confusion, seizures, loss of consciousness, or even death, according to the American Diabetes Association. “Low blood sugar is very dangerous for a diabetic person,” Gandhi says.

Find a plan that works for you. Plans for IF vary from those that restrict calories two or three days a week and those that restrict eating to certain periods of the day to more strict plans that include fasting for up to 36 hours at a time for 7 or 14 days. The key is to find a plan that you can stick with for the long term.

Be prepared for side effects. It’s common to have headaches, cramps, constipation, or diarrhea, at least initially. “If you’re feeling very unwell, stop. You might be hungry, but you shouldn’t be lethargic or throwing up,” Dr. Fung says.

Eat healthily. Your diet should consist of whole, unprocessed foods, including nonstarchy vegetables, protein, and healthy fats, as well as a multivitamin and plenty of water to prevent dehydration and headaches. A healthy diet will help you lose or manage your weight and keep your blood sugar level steady.

Don’t skip breakfast. Always start the day with a diabetes-friendly breakfast within one to two hours of waking up. “Our blood sugar naturally rises in the morning — that’s how we wake up — and we don’t want that to be followed by a drop. We want to maintain a steady, stable blood sugar throughout the day,” Gandhi says.

Keep your expectations in check. An IF plan doesn’t work for everybody, and your medical team may not feel that it’s a good fit for you. It’s important to consult these professionals before giving IF a try, as going for long periods without eating when you have diabetes can be dangerous or, at the very least, not produce the results you want. “If you’re recommending something to a patient, you have to look at the whole picture and think, Can this fit into somebody’s life, will they be happy, and will the results outweigh the risks.” Gandhi says. “To me, the answer is no. You will see some weight loss, but it’s not going to be in a healthy way; it’s not going to be in a sustainable way.”

Get support. If you do get the all clear to try IF, experts advise following the plan with a friend or joining an online community or social network to help motivate you to stick with it.

Intermittent Fasting and Diabetes: The Bottom Line

Although IF may help you lose weight, which can help you better control diabetes, it’s important to consult your medical team. Together you can decide what’s most sustainable and safe for you as an individual. Due to the risk of potential blood sugar swings, full-blown IF may not be for you, especially if you aren’t controlling the diabetes well. Instead, decreasing your portion sizes, increasing your physical activity between meals, and making healthy food swaps — all of which align with IF — may be a better approach.

5:2 Fasting Diet – Intermitent Fasting Diet

The 5:2 intermittent fasting (IF) diet, more commonly referred to simply as the 5:2 diet, has become a popular approach to eating in recent years. Studies have shown that the diet helps with weight loss and may also reduce insulin resistance, both of which are of particular interest for many people with type 2 diabetes or borderline diabetes. One reason for the popularity of the diet is that it allows a certain amount of flexibility, in comparison to low calorie diets, on most days of the week. Many people use fasting alongside a low carb diet.


The idea of the diet is that short periods of fasting prompt the body to repair damage but not enter a starvation mode of conserving energy. Whilst the theory has yet to be conclusively proved, clinical studies have shown promising results for the diet, however it has only been examined over relatively short time spans, of less than a year. There are several ways that intermittent fasting can be used to manage blood glucose levels, however this guide focuses on the 5:2 approach.


The 5:2 intermittent fasting diet is based on a simple idea. 5 days a week you stick to meeting the daily calorie intake advised for people of a healthy weight, that being:

  • 2,500 kcal per day for men
  • 2,000 kcal per day for women

For the other 2 days each week, the diet stipulates that you have only around 25% of the values above, which is equal to:

  • 600 kcal on these days for men
  • 500 kcal on these days for women

The fasting days can be taken at any time during the week as long as you do not take 2 fasting days consecutively.


Clinical studies have shown that the benefits of intermittent fasting are largely similar to those of a calorie restricted diets . The most commonly reported benefits among people from following the 5:2 diet: Research has shown that periods of fasting can help to improve life expectancy and decrease risks of diseases including nerve disorders, Alzheimer’s disease and cancer. However, whether these benefits apply to a 5:2 fasting diet cannot be confirmed as long term clinical studies have yet to be performed.


Whilst shorter term studies have displayed promise for intermittent fasting diets, long-term safety of the 5:2 diet is yet to be determined. As with any diet plan, you should always consult your GP or diabetes health team before making any significant changes to your diet as they could affect blood glucose levels or impact on your medication.


The fact that intermittent fasting shows evidence of improving insulin sensitivity may be an attractive option for people with a BMI over 25, borderline diabetes (prediabetes) or with type 2 diabetes but not on blood sugar-lowering medications . The diet may be good for people who can handle single days of significantly restricted calorie intake in preference to modest calorie restriction every day. On fasting days, the body will be forced to use stored energy from the body, fat and stored sugar (glycogen), which can help with weight loss and may improve blood glucose and cholesterol levels. If you are on insulin, or hypo causing medication, such as sulphonylureas or glinides, an intermittent fasting could significantly increase the risk of hypos. Your doctor should advise you on whether the diet is appropriate.


If you have type 1 diabetes, following a 5:2 diet could make diabetes management more difficult to achieve and could significantly increase the risk of hypoglycemia . If your health team are happy for you to start an intermittent fasting diet, they may wish to monitor you more closely to reduce the likelihood of hypoglycemia or increased ketone levels occurring.


A study published in 2010 reviewed 107 women, between the ages of 30 and 45, with BMI values ranging between 24 and 40. The participants were randomly assigned to one of two diets, either continuous energy restriction (CER) or intermittent energy restriction (IER). The CER dieters had a reduced calorie intake of 1,500 kcal through the week, while the IER diet group followed the 5:2 fasting plan. At the end of the study, both sets of dieters lost a similar amount of weight on average, and similar improvements were also seen in levels of triglycerides, LDL ‘good’ cholesterol and blood pressure. One area, however, where intermittent fasting was shown to be stronger than continuous calorie restriction was in reducing fasting insulin levels and insulin resistance.


Depending on your outlook, the 5:2 diet may be seen as more or less practical than a continuously reduced calorie diet. The benefit being that on most days you needn‘t consume less than the daily recommended calorie limit. However, some people may find that calorie intakes of 500 or 600 calories a day are too low to be practical. For best results, it’s recommended to follow basic healthy eating rules, such as having a good intake of vegetables, fruit, and limiting intake of processed foods where possible. During the fasting days, you will need to rely on very low calorie meals to stay within the daily 500 or 600 calorie counts.


An example of good meal picks on fasting days include those based low fat foods such as:

  • Eggs (65 kcal per medium egg)
  • Grilled chicken breast without the skin (190 kcal per 100g)
  • Prawns (105 kcal per 100g)
  • Non-battered white fish (135 kcal per 100g)

Vegetables tend to be low calorie but if you need very low calorie vegetables, the following vegetables are particularly good options:

  • Cucumber (15 kcal per 100g)
  • Celery (20 kcal per 100g)
  • Bell pepper (26 kcal per 100g)

90,000 What are the benefits of short-term fasting for diabetes mellitus?

According to some reports, about one in 10 people in the United States and Canada is diagnosed with type II diabetes, which is associated with other serious illnesses and the risk of early death. It is generally accepted that the United States spends $ 245 billion annually. USA to control only this disease.

Lifestyle changes are a key aspect of symptom management, but alone are not a way to control blood glucose levels.Meanwhile, bariatric surgery is effective, but this surgery is associated with a number of risks. Medicines can help control symptoms and prevent complications, but they cannot stop the disease from progressing.

To understand whether planned short-term fasting can help alleviate the symptoms of diabetes, the Intensive Dietary Management Program conducted a study with 3 people aged 40–67 years to test the method. They took a variety of medications to fight the disease, as well as daily prescribed doses of insulin.In addition to type II diabetes, all patients had high blood pressure and high cholesterol levels.

2 men fasted every other day for 24 hours, and the third – 3 days a week. On fasting days, they were allowed to drink very low-calorie drinks such as tea, coffee, water, or broth, and eat one very low-calorie meal in the evening.

Before starting the fast, they all attended a 6-hour nutritional workshop that provided information on the development of diabetes and its effects on the body, insulin resistance, healthy eating, and dietary management of diabetes, including therapeutic fasting.

Participants followed this diet for approximately 10 months, after which they re-measured their fasting blood glucose, glycosylated hemoglobin (HbA1c), body weight and waist circumference.

All 3 participants managed to stop insulin administration within a month after the start of short-term fasting. In one case, this took only 5 days.

2 men were able to stop taking other antidiabetic drugs, while the third one stopped taking 3 out of 4.All participants showed a decrease in body weight by 10-18%, a decrease in the level of glycosylated hemoglobin, which can help reduce the risk of complications in the future.

Patient feedback was positive and all 3 men were able to adhere to their regimen without much difficulty.

This is an observational study and looks at only 3 cases – all in men. Thus, it is impossible to make an unambiguous conclusion about the great success of the application of this principle for the treatment of type II diabetes mellitus.

“The use of fasting therapy for type II diabetes mellitus is mind-boggling,” the authors note. “This series of cases has shown that 24-hour fasting regimens can significantly reduce or eliminate the need for antidiabetic drugs.”

The research results are published in the journal “ BMJ Case Reports “.

Based on materials from www.bmj.com

90,000 Interval Eating: Good or Bad? | Culture and Lifestyle in Germany and Europe | DW

There are hundreds of diets for fast weight loss: kefir, protein, milk salad, egg, cabbage, fresh juices, Japanese, Hollywood… It is impossible to list everything. Relatively recently, a new one has appeared, and it is also very simple. Her fans (and female fans) consider this diet to be the most effective. Its basis is the so-called interval nutrition. In fact, there is nothing fundamentally new in this: we are talking about the fact that it is still better to give dinner to the enemy. The truth is known to everyone, but in practice not everyone follows it. And in vain, according to the authors of the current research on the feasibility of healthy fasting.

How much to eat, how much not to eat

Intermittent fasting (or nutrition) has been talked about relatively recently.With the help of a certain diet, it is relatively easy to get rid of excess weight, establish an optimal energy balance in the body and even regulate insulin levels – in any case, the adherents of this diet say so.

The so-called interval diet (or intermittent fasting, abbreviated IF) is based on alternating periods of eating with periods of fasting. There are various models: from “5/2”, in which you can eat anything for five days, and in two fasting days, reduce the intake of calories to 500 kcal, to “16/8” (for 16 hours you can only consume unsweetened drinks, and then 8 hours are allowed to eat, as usual).Alternate Day Fasting (ADF for short) involves alternating light meals (500 kcal) with “full” days.

There are also more radical options for interval feeding, for example, the so-called “warrior’s diet”: complete fasting for 20 hours, and in the remaining four hours of the day – increased food intake, even turning into a frank catching up of “lost”. Doctors strongly advise against the latter option, since the benefits of this form of fasting are scientifically questionable.But to the rest of the options – and especially to the “10/14” and “5/2” models – experts are more favorable, referring to the rather promising results of the studies already carried out.

Research and its shortcomings

Fasting – that is, forced or voluntary refusal to eat – has been known to mankind since ancient times. It is believed that intermittent fasting “spurs” the work of various functions of the body, including regenerative, improves metabolism, and has a beneficial effect on the activity of the brain.This is what piqued the interest of scientists looking for optimal therapy for patients with cardiovascular disease, diabetes, obesity, or undergoing chemotherapy for cancer.

Drinks without sugar are allowed during fasting – tea, coffee, water

However, the studies carried out so far, unfortunately, are too short-term, and the number of participants in groups is minimal, nutritionist Tilman Kühn from the German Center regrets Cancer Research (DKFZ) in Heidelberg.Long-term studies have so far only been conducted in animals, he said.

However, the results obtained in recent studies of interval feeding at the University of the Harz, as well as in Norway and Australia, are quite comparable with the study led by Tillman Kühn in Heidelberg. For almost a year, German doctors compared the success of participants in the 5/2 intermittent fasting group with a group of participants who reduced their weight by reducing calories by 20%, and with a group of probands (30 people) who ate as usual.

It turned out that the participants in the “interval” group lost weight almost as much as those who belonged to the calorie reduction group reduced it. In addition, the level of insulin in the blood of the probands of both groups improved, and the pressure became more stable. That is, scientists did not find much difference between intermittent fasting and calorie reduction. But adherents of the interval diet, the most acceptable for the body, are less likely to complain about poor sleep, and in the morning they experience a real surge of vigor.

Which is more effective – an interval diet or a low-calorie diet?

However, fasting, whatever it may be, cannot be considered a universal, miracle cure that relieves not only excess weight, but also diseases, warns Tilman Kühn. “It’s great if someone managed to find their own ‘rhythm’ of food intake, with an obvious positive effect for everyone,” says the doctor. This means that a particular person benefits from a certain, specific type of diet, but there is no common optimal diet for everyone.

See also:

  • Which foods prolong life and which don’t


    On average, every German citizen drinks about 160 liters of coffee a year. But controversy about this drink continues. If you read that it dangerously increases blood pressure or even contributes to the occurrence of cancer, then, on the contrary, experts say that coffee prevents a number of diseases. It is known for sure: studies have shown that this drink does not bring obvious harm to coffee lovers.

  • Which products prolong life and which do not


    Not so long ago, doctors and scientists advised to take instead of butter its substitute – margarine, because an excess of animal fats is harmful. Now, on the contrary, margarine is criticized: there are too many chemical additives in it. But experts recommend ghee, because it contains less so-called saturated fatty acids.

  • Which foods prolong life and which don’t

    Red wine

    Does a glass of red wine a day really prevent cardiovascular diseases and reduce the risk of myocardial infarction? Fact: years of research have not yet refuted this.The prophylactic effect is attributed to the miraculous substance resveratrol contained in red wine. But do not forget: we are talking only about one glass a day, no more!

  • Which foods prolong life and which don’t


    We cannot do without cholesterol, because it is contained in cell membranes. There is so-called “good” and “bad” cholesterol. It used to be thought that there should be as little “harmful” in the blood as possible, and as much “useful” as desired.Now it is known that the level of “useful” must be limited. Doctors are calling for a healthy balance. You can eat one egg a day in peace. But instead of meat.

  • Which foods prolong life and which don’t

    Vegetables from the freezer

    The boom in vegetables from the freezer seems to have passed. Most people prefer fresh, bought in a store, in the market, from a tray. But nutritionists pay attention to the fact that vegetables, fruits and berries that have undergone shock freezing immediately after harvest retain more nutrients and vitamins than the so-called “fresh” ones that have already lain on the counter.

  • Which products prolong life and which do not


    Monosodium glutamate is known as a universal food additive E621 – the so-called “flavor enhancer”. In Germany and many other European countries, it is forbidden to add it to baby food. Does this mean that it is harmful? Artificial glutamate, and even in large quantities, as, for example, in chips – of course. And even, perhaps, natural (say, in soy sauce or Roquefort cheese).

  • Which foods prolong life and which don’t


    Ceylon cinnamon is an excellent antioxidant, a spice that gives a unique taste to baked goods.However, in the bark of a cheaper version – Chinese cinnamon (lat.Cinnamomum aromaticum) – coumarin was found, an excess of which can have a devastating effect on the kidneys and liver. The recommended daily allowance is no more than 0.1 mg per kilogram of body weight. That is about one big gingerbread.

  • Which foods prolong life and which don’t


    The debate about how much water to drink per day does not stop. Usually, our body itself knows how much fluid it needs: we drink to quench our thirst, and we get the rest with food.But doctors insist on a daily rate of at least 2.5-3 liters per day. And supposedly you need to drink without waiting for the thirst to overcome, especially on hot days.

  • Which foods prolong life and which don’t


    Milk is useful only for children, many adults have problems with it – due to lactose intolerance. This is the conclusion reached by German doctors. And Swedish scientists have found that milk lovers live less and get sick more often. This is evidenced by the results of a long-term study, in which more than 100 thousand people took part.

  • Which foods prolong life and which don’t

    Wheat and other grains

    Bread is another basic product that scientists are now questioning about. It is undeniable that baked goods containing gluten (gluten) in many people – especially children – cause intolerance. In addition, yeast, nuts or seeds used in bread making are often a problem.

  • Which foods prolong life and which don’t


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  • Dangerous and wholesome food

    Which food do you prefer?

    For the 60th time, on May 29, most countries celebrate World Healthy Digestion Day, established by the World Organization of Gastroenterology (WOG) and the World Health Organization (WHO).It is held to draw public attention to the problems of digestive disorders and to find effective ways to combat them. So which foods are good for us and which should be avoided?

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    Fast food

    The main disadvantage of fast food is the trans fats it contains, obtained from vegetable oils during the hydrogenation process: liquid vegetable oils are saturated with hydrogen bubbles at high temperatures. As a result, trans-isomers with a distorted molecular structure are formed.Once in the body, such molecules disrupt metabolic processes in cells, which can lead to chronic inflammation.

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    It is known that red wine can be good for the body – but only if you drink one glass. Consuming more is only harmful. And even more so when it comes to stronger alcoholic beverages. Alcohol abuse is strongly reflected on the face: it turns red and swells.In addition, alcohol contains a lot of sugar that breaks down collagen fibers.

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    Permanently exclude white bread and pasta from your diet! The fact is that they contain too many carbohydrates, which are nothing more than sugar molecules. Overuse of white flour baked goods leads to glycation – the sugaring of collagen fibers, sticking them together and breaking them down. As a result, our skin loses its elasticity and ages quickly. Not to mention digestive disorders.

  • Dangerous and wholesome food


    Coffee speeds up metabolism, which means it stimulates weight loss.On the other hand, research shows that as early as two to three cups of coffee a day can cause sudden changes in blood pressure, which can lead to heart problems. Coffee, drunk on an empty stomach, increases the acidity of the stomach, and this is a direct path to the development of ulcers and gastritis. And coffee also has a diuretic effect, which causes dehydration of the body, kidneys suffer.

  • Dangerous and wholesome food

    Coconut oil

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  • Dangerous and wholesome food

    Green tea

    Green tea is a storehouse of antioxidants, including polyphenols and flavonoids, which prevent skin aging and the appearance of wrinkles, as well as protect us from cancer and other diseases.The composition of its leaves also includes a unique amino acid – L-theanine, which has a relaxing effect and protects a person from the effects of stress on his body.

  • Dangerous and wholesome food

    Bitter chocolate

    Cocoa, which is 80 percent dark chocolate, is a real source of powerful antioxidants, saturated fatty acids and flavonoids, which help to improve the elasticity of blood vessels, blood circulation, and the normalization of arterial pressure.Not to mention, this product evens out the complexion and protects the skin from the harmful effects of the sun.

  • Dangerous and wholesome food


    The fruits of this tropical plant are a valuable dietary product, because they have a very low calorie content: there are only 39 calories per 100 grams of pulp. The low fructose content of papaya promotes proper digestion, while its beta-carotene, vitamins C and E improve complexion and protect the skin from sunburn.

  • Dangerous and wholesome food


    In addition to improving vision, carrots also have a wonderful effect on the skin. The fact is that this product is rich in beta-carotene, which is synthesized in the body into vitamin A, and it helps prevent the overproduction of cells in the epidermis, where excess sebum, combined with dead cells, clogs the pores. Carrots are also good for improving bowel function and strengthening the immune system.

  • Dangerous and wholesome food


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  • Dangerous and wholesome food


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Diabetes mellitus

Diabetes is a disease associated with high blood sugar (glucose) levels.

Why is blood sugar needed and where does it come from?

First, sugar enters the bloodstream from food; secondly – from the sugar reserves that are contained in the liver. Glucose is the main source of nutrition for all cells (the smallest building blocks of the body). Inside the cell, glucose is converted into energy, which allows the cells to work, and, accordingly, the entire body (as a car cannot drive without gasoline, so a cell cannot work without fuel, which is sugar for it).However, glucose can penetrate into the cell only with the help of insulin.

What is insulin and where is it produced?

Insulin is a hormone produced in the pancreas (beta cells). Beta cells register an increase in blood sugar and respond by sending a certain amount of insulin into the bloodstream, thereby lowering blood sugar levels.

What causes type 2 diabetes?

1. Obesity is the main cause of type 2 diabetes (about 80% of patients with type 2 diabetes are overweight)
2.Heredity (if one parent is sick, then the likelihood of developing diabetes is about 40%, if both parents are 75%)

What happens with type 2 diabetes?

In this disease, the pancreas produces insulin, but it is either insufficient or it does not work well (in most cases, this is due to an excess of adipose tissue in the body, which interferes with the action of insulin, while the insulin content in the blood can significantly exceed the norm). As a result, a large amount of sugar accumulates in the blood and its level rises.

Who has type 2 diabetes?

Previously, it was believed that this type of diabetes mainly affects people over 40-45 years old. However, in recent years, type 2 diabetes mellitus has noticeably “younger”, which is associated with a high prevalence of obesity, incl. and in young people

How is diabetes mellitus diagnosed

The diagnosis “diabetes mellitus” is established when the blood sugar level (glycemia) on an empty stomach is more than 6.1 mmol / l (fasting glycemia means the blood glucose level determined in the morning before breakfast after preliminary fasting for 8 hours).

Also, the diagnosis of diabetes mellitus can be established after the detection of glycemia more than 11.1 mmol / l at any time of the day.

Occasionally, an oral glucose tolerance test is performed to clarify the diagnosis.

(In the morning on an empty stomach, blood is taken for sugar, after which the patient drinks 75 grams of glucose and after 2 hours the blood sugar level is re-examined). With a glycemic level of more than 11.1 mmol / L, a second measurement establishes a diagnosis of diabetes mellitus.

What is the difference between type 1 diabetes mellitus and type 2 diabetes mellitus?

In the first type of diabetes, the pancreas stops producing insulin.The disease occurs at a young age (usually before the age of 40). For these patients, the only treatment is lifelong insulin

How is type 2 diabetes treated?

1. Diet
2. Exercise
3. Sugar-lowering tablets
4. Sometimes, insulin is prescribed

Why do you need to control your blood sugar?

Regular monitoring of sugar levels is the key to successful treatment and prevention of complications of diabetes !!!

It is important to know that periodic testing of blood sugar in the clinic is not sufficient for good control.It is imperative to regularly measure your blood sugar yourself.

How often should measurements be taken?

Patients with type 2 diabetes mellitus receiving antidiabetic pills should take several measurements per week (at different times of the day). Once every 2 weeks, it is advisable to test blood sugar 4-6 times a day (throughout the day: before meals and 2 hours after meals).

What are blood sugar targets?

These are the sugar levels you should aim for to avoid complications:

• Fasting (before meals) 3.3-6.0 mmol / l
• 2 hours after meals up to 7.8 mmol / l

What is hypoglycemia?

This is a condition in which the sugar level drops below 3.3 mmol / L. At the same time, you may feel shivering, chills, sweating, hunger, irritability, headache, pallor, palpitations.

What to do in case of hypoglycemia?

You need to eat 4 lumps of sugar or drink 1 small packet of juice (200 ml). Do not use chocolate, sweets, confectionery, bread and fruits to relieve hypoglycemia – they slowly increase blood sugar !!!

How to eat properly with type 2 diabetes?

• Food must contain a sufficient amount of carbohydrates (about 60%), i.e.because they are the main source of nutrition for the cells of the body. Carbohydrates include: bread, potatoes, pasta, buckwheat, rice, oatmeal and other grains, as well as fruits and vegetables. It is important to understand that although these foods increase blood sugar, they do it slowly!
• Exclude fast-digesting carbohydrates (honey, jam, juices, sugary drinks, sugar, sweets), because they raise blood sugar very quickly!
• Weight loss is an integral part of diabetes care. To this end, it is necessary to limit the amount of fat in food as much as possible to 15%.Fats do not increase sugar, they lead to weight gain !!! Fatty foods include: caviar, fatty fish (salmon, salmon, carp, sturgeon, herring) and any fatty meat, canned food in oil, all sausages, sausages and small sausages, lard, cheese with a fat content of more than 40%, seeds and nuts, fatty dairy products, mayonnaise). It is important to know that both butter and all types of vegetable oil are fats and contribute to weight gain, therefore, it is necessary to limit any of its types!
• The daily diet should contain about 30% protein (low-fat fish (perch, cod, icefish), lean meat and poultry; dairy products with a fat content of less than 1.five%; cheese with a fat content <30%). Proteins do not increase blood sugar !!!!
Helpful Tips for Reducing Caloric Content
• Do not fry! Use other cooking methods: baking, boiling, steaming, on a grill, on an open fire
• When cooking meat, poultry, remove the skin and remove all visible fat before cooking
spices, mustard, vinegar, lemon juice) instead of oil and mayonnaise
• Start your meal with a glass of mineral water and vegetable salad, ie.about. You will be able to “trick” the stomach and the satiety process will occur faster
• Try to eat in small portions 4-6 times a day

Is it possible to drink alcoholic beverages in case of diabetes mellitus?

1. Alcohol lowers blood sugar and can lead to the development of hypoglycemia (lowering sugar below 3.3 mmol / l), therefore, you should always eat (bread, potatoes, cereals, pasta, fruits) before consuming it. Remember that in the case of alcohol consumption, the symptoms of hypoglycemia may be “blurred”
2.Drinking alcohol should be moderate !!! (no more than 1 glass of dry wine (or brut) or 50 g of strong alcoholic drink per evening)
3. Eliminate sugary alcoholic beverages
4. Remember that drinking alcohol (especially in large quantities) while being treated with certain drugs to reduce sugar is unsafe (e.g. metformna)

What is antihyperglycemic therapy?

Antihyperglycemic therapy refers to the various drugs prescribed for diabetes mellitus to lower blood sugar levels.What kind of pills to prescribe to the patient is decided in each case individually by the doctor.

Physical activity

• Regular exercise is extremely beneficial for all patients with diabetes mellitus. they lower blood sugar, help reduce weight, reduce the risk of complications
• Exercise should be tailored to your age, diabetes complications and comorbidities
• Moderate exercise, such as walking instead of driving, is recommended for most patients , climbing the stairs instead of the elevator
• Remember to exercise regularly (daily walks for 30 minutes, swimming for 1 hour 3 times a week).
• Exercise is not recommended with blood sugar levels above 13-15 mmol / L – this can lead to an additional increase in blood sugar
• In the absence of serious complications and concomitant diseases, patients with type 2 diabetes can engage in any sports
• Necessary remember that during physical exertion, as well as within a few hours after it, sugar can drop, therefore, in order to prevent hypoglycemia, it is necessary to refuel before and after exercise (for example, with fruits).
• If the intensity of exercise is high (jogging, aerobics, etc.), it is better to drink sugary water during exercise. Before and after exercise, be sure to check your sugar level !!!

90,000 Scientists have found out how intermittent fasting affects health.

A group of scientists from the University of Graz (Austria) for four weeks observed 60 volunteers who were on a special diet – on intermittent fasting. According to a study published in Science, the effect of the experiment confirmed the scientists’ expectations.

Intermittent fasting, or intermittent, cyclic, intermittent, has recently been extremely popular. There was circumstantial evidence that it not only brings health benefits, but possibly prolongs life. However, most of these statements were based either on hypotheses, or the results of this kind were obtained in the course of studies on animals. The question whether these results can be applied to humans to the same extent has been open until now.

The essence of this diet is to limit the time of meals, i.e.That is, when drawing up your diet and menu, you need to create periods when you can’t eat.

To get more clarity on this issue, Austrian scientists invited volunteers to a “pilot” four-week project. According to the experimental conditions, 60 participants, middle-aged men and women, were slightly overweight, but healthy, and were neither vegans nor vegetarians. Half of them (the control group) had to maintain their previous eating habits, while the other half ate a specific intermittent fasting technique.

After four weeks of the experiment, each of them lost an average of 3.5 kilograms, while the subjects of the control group – only about 200 grams.

Among other positive effects, the following were noted: lowering blood pressure; improvement of metabolic processes; an increase in the concentration of polyunsaturated fatty acids in the blood – substances that, according to a number of observations, reduce the risk of heart attacks and other cardiovascular diseases.

The participants had “no side effects even after 6 months of the diet,” the article says, and the diet generally improved “physiological and molecular markers of aging in healthy, non-obese people.”

However, due to methodological shortcomings, a study by Austrian scientists, one of the pioneers in this matter, cannot draw unambiguous conclusions on the exceptional benefits of this diet, writes NZZ.

But in the meantime, there are a number of studies confirming the benefits of intermittent fasting. For example, American scientists have recently shown that fasting for one day reduces inflammation in the body without weakening the immune system.

While fasting for 48 hours has already had a negative impact on the body’s defenses.

Thus, not every type of intermittent fasting is equally beneficial. Therefore, it is all the more important to carefully study the benefits and risks of each type of diet.

Intermittent fasting – Medical center “Kedr”

How to keep focus always? Strength? Energy? Charge? Be energized and 100% healthy?

Most often people are looking for an answer in psychology. That you need to somehow work with your head and everything will be fine. This is partly true, but sometimes the problem lies precisely in health.

Insulin resistance is a condition in which fatigue, a tendency to edema and a lack of energy appear. Also, spots of red color appear on the body, papillomas, pigmentation on the joints of the fingers, neck, tummy grows, chilliness, dry skin, hair loss. You’ve probably noticed some of this. But this is also followed by diabetes, excess weight, poor memory, skin problems …

But don’t worry. Perhaps you already had some similar problems. But you don’t even need to go to the hospital.

Specialists from the Cedar Center will help you deal with insulin resistance or, in another way, with the problem when your body has stopped hearing insulin signals.

An important role in the restoration of insulin sensitivity is played by a proper diet and intermittent fasting – a diet style with elements of the paleo and keto diet.

The basis of such a therapeutic nutrition is the management of your hormones: insulin, human growth hormone (somatotropic hormone – STH) and glucagon.Growth hormone is produced during sleep in the presence of melatonin (sleep in complete darkness and go to bed no later than 22-23 hours). It works until we eat carbohydrates (porridge, bread, sugar), which stimulate the release of insulin by the pancreas.

Insulin is an antagonist of STH, a hormone not only for growth, but also for the restoration of all breakdowns in the body. If a person does not eat often, it is better – in the morning, nothing until 12 – 14 o’clock, except for butter, and had dinner three hours before bedtime – 2-3 times a day, this is intermittent fasting.

What oils are considered suitable: Omega 3 and 9, vitamin D3, fish oil – better Cod liver oil – cod liver oil, or Tulenol in courses of 1-2 months, MCT oil, which are also available in capsules as nutritional supplements. The dose will be selected by the doctor.

The pancreas, when we are not eating, releases the hormone glucogone into the bloodstream, which produces glucose from adipose tissue (primarily cholesterol deposits in the liver) – this is gluconeogenesis. In the blood, the glucose level rises and is kept at a stable level.At the same time, hungry dizziness disappears, the energy balance is restored, and all toxins and metabolic debris are used (as fuel) and excreted from the cells.

Of course, you need to drink enough, you can drink herbal teas and coffee without milk, some useful oil, tasty, such as coconut or MCT oil, olive, ghee, pumpkin, nut oil are also suitable – this will not cause an increase in insulin. It is safe to fast for 24-48 hours, after 18 hours without protein-carbohydrate food, the process of autophagy develops – self-digestion of toxins, amino acid fragments and other “garbage” in cells – detoxification at the cellular level.This eating style is also suitable for losing weight once and for all.

90,000 Research: Brunch Increases Risk of Type 2 Diabetes – News from Ukraine and the World

According to a study presented at a virtual conference of the Endocrine Society, eating in the morning is associated with lower insulin resistance and a lower risk of developing type 2 diabetes. These findings were part of the scientific work on intermittent fasting.

Read also Is it worth forcing yourself to have breakfast and 6 more important questions about breakfast

We found that people who start eating earlier have lower blood sugar levels, regardless of whether they have limited themselves to food for 10 hours before this, says Dr.Marriam Ali, lead author of the study.

Conclusions on Intermittent Fasting

How to Eat Good Breakfast / Photo Pexels

Ali and team analyzed data from 10,575 American adults to find out if there was a relationship between food intake, blood sugar and insulin levels.

Scientists have found that intermittent fasting is associated with high insulin resistance. This means that people who fasted 90,033 reacted less to insulin, the hormone that regulates blood sugar .It is insulin resistance that is a risk factor for the development of type 2 diabetes.

However, people experienced decreased levels of insulin resistance if they ate breakfast at 8:30 am, whether they were fasting or not.

Although fasting did not significantly affect blood sugar levels, eating early was shown to have an effect. Therefore, scientists suggest that breakfast has significant metabolic benefits.

Breakfast supports a healthy weight and stable energy

How to Eat Good Breakfast / Photo Pexels

Breakfast does not have to be the most important meal , but it can increase energy levels and maintain it throughout the day.

Nutritionists recommend to start your day with a combination of protein, healthy fats and fiber . This can be yogurt with fruits and nuts, or whole grain toast with eggs and vegetables.

Interesting Fried, boiled or scrambled eggs: which method of cooking eggs is considered the most useful

Without eating until noon: why is intermittent fasting useful?

Prior to pregnancy, for several years I easily went without food until noon.At noon, I could drink freshly squeezed juice, smoothies or a snack with seasonal fruits, and the first full meal in the form of porridge and salad, as a rule, was after 12:00 pm. Cleansing and restoring the body, a feeling of lightness and vigor during the day, strengthening the immune system and getting rid of many health problems – the benefits of intermittent fasting and long breaks between meals are now being discussed more and more often. How it works? What gaps between meals will benefit? Why are more and more experts not recommending snacking often during the day? And for whom is such a system not suitable? The opinion of experts on intermittent fasting is in this post.

Material prepared by: Daria Bukhman

What is intermittent fasting?

The concept of “intermittent fasting”, which is often used by Russian experts, does not fully reflect the essence of the Western approach and does not sound entirely clear. A more accurate translation, which in itself explains the essence of the practice, will be “short-term refusal to eat.” Unlike traditional fasting with intermittent fasting, the periods of time without food are much shorter, but a similar practice is repeated at regular intervals every day or every week.

How did our ancestors eat?

Many modern diets and health trends are based on the eating habits of our ancestors. And the principle of intermittent fasting is no exception. In the days of hunter-gatherers (namely, from the late Paleolithic, according to scientists, our DNA has hardly changed), hunger was the norm, because no one knew when to catch another game or find plant food. Thanks to this alternation of moments of eating with periods of fasting, the human body has learned, firstly, to effectively break down fat (and not glucose) for energy, entering a state of ketosis-carbohydrate starvation of cells.And secondly, it became more adaptive and able to switch between burning glucose and burning fat for fuel. It is this ability that we do not train at all, eating every three hours, and sometimes more often (after all, no one canceled snacks :).

Why is this necessary?

Recently, there has been more and more scientific research on the benefits of this practice. Intermittent fasting promises to reduce inflammation in the body, regulate blood sugar, improve mental function, increase energy levels, and can also prolong life, prevent and help fight cancer, diabetes and cardiovascular disease at the level of cell repair.

Expert opinion

“It’s hard to imagine our ancestors crawling out of the caves, asking:“ What for breakfast today? ” In those days, refrigerators did not exist, there was nowhere to store food. For me, intermittent fasting is a kind of reunion with ancestors, ”- Dr. Stephen Gundry, cardiologist, author of The Plant Paradox.

“Have you ever noticed that when you are sick, you have no appetite at all? This is an absolutely normal reaction of the body.Your body itself tries to lower blood glucose levels to fight infection. Intermittent fasting is not just a trend, all fasting mechanisms are embedded in our DNA. ”- Dr. Jason Fung, fasting practitioner, author of The Complete Guide to Fasting.

“I myself use the intermittent fasting technique every week and highly recommend it to my patients. It’s amazing how simply avoiding food can significantly reduce markers of inflammation in the body. ”- Dr. William Cole, functional medicine practitioner.

“During my many years of practice, I have witnessed how fasting healed patients from arthritis and lupus, helped to cope with eczema and psoriasis, and quickly stopped the development of cardiovascular diseases. At the same time, the healing is complete, without a rollback, and in fact, in many cases, operations were recommended that did not have to be resorted to in the end, ”- Dr. Joel Furman, practicing family doctor, nutritionist, author of Fasting and Eating for Health.

“Intermittent fasting is a very fashionable philosophy now, which, among other things, helped to debunk the myth that eating often small meals throughout the day improves metabolism (and for that I am grateful to her).I want to draw your attention to three points: listen to your body and do not harm yourself. If you feel that fasting is not for you, then you should not torture yourself. Second, fasting in any form is dangerous for people (especially women) with eating disorders such as anorexia and bulimia. Thirdly, the method of intermittent fasting does not take into account the thousands of years of experience in Ayurveda, which suggests that some types of people tolerate fasting more easily, while others are much more difficult. Therefore, I prefer a well-structured detox program to intermittent fasting, ”- Kimberly Snyder, nutritionist, author of the best-selling The Beauty Detox Solution.

“Just as we need sleep to reboot and recover, our digestive system needs to stop eating for a while. I love to use intermittent fasting in my practice to fight inflammation and strengthen immunity, ”- Dr. Amy Sha, board certified digestive specialist.

“I am often asked if women can starve. Long-term fasting can no doubt turn off the reproductive system in women, but short-term fasting can rejuvenate a woman, increase energy levels, improve gut flora. ”- Felice Gersh, board-certified gynecologist, founder of the Integrative Medical Group of Irvine in California.

Several hours to several days – types of intermittent fasting

There are many types of intermittent fasting, but perhaps the most popular practices are:

Method 16/8

This type of fasting involves 16 hours without food for men and 14-15 hours for women every day. Thus, you are trying to fit your meals into a window of 8-10 hours (usually 2-3 meals). For example, having dinner at 6:00 pm, you eat breakfast at 9:00 am-10:00 am the next day, thus fasting for 15-16 hours (most of which, hopefully, you sleep).

Method 5: 2

This type of fasting involves eating a normal meal 5 days a week and reducing calories to 500-600 on the remaining two days. This subgroup includes detox programs with daily calorie restriction.

Alternate day fasting
Method 12-6

In fact, we skip breakfast, having dinner at 18.00, and break the fast with lunch at 12.00.

Warrior’s Diet

The only meal during the day is dinner, that is, fasting can last up to 22 hours (from dinner to supper).You can read more about the system and selected quotes from the book “The Warrior’s Diet” in this post.

It is important to remember that the first meal after a break should be nutritious, satisfying and healthy, otherwise all your body’s detoxification work during intermittent fasting actually loses its meaning. A healthy vegetable fat smoothie, kitchari, freshly squeezed vegetable juice, salad, and an omelet are great options.

Ayurveda and intermittent fasting

According to Ayurveda, a 12-hour break between dinner and breakfast is extremely beneficial for health, however, longer fasting will not benefit all doshas.

It is believed that fasting is not suitable for people with a predominant vata dosha. If they do decide to try it, then it is better to experiment in the warm season. Fasting is extremely difficult for pitta people due to their good appetite and strong agni. Kapha is the dosha for which fasting is most beneficial and easiest to perform due to its slow metabolism. It is this category of people who are usually not hungry in the morning and can easily skip breakfast.

For whom is intermittent fasting not suitable?

If you have gallbladder problems

During fasting, the gallbladder does not release bile, which is secreted by the liver.Therefore, bile during fasting becomes very concentrated and at the moment of coming out of fasting (during the first meal) it can release small stones that can clog the duct.

If you have or have an eating disorder

Intermittent fasting can seriously aggravate illnesses such as bulimia, anorexia, or other eating disorders.

If you have adrenal insufficiency or adrenal fatigue

Fasting can increase the concentration of cortisol, a stress hormone, in the blood, making the adrenal glands work even harder.

If you are pregnant or breastfeeding

Intermittent fasting can be an interesting experiment and provide noticeable benefits, but only if your body is ready for it.