Is Intermittent Fasting Safe for People with Diabetes?

Medically Reviewed by Dr Chandana, MBBS , MS

Diabetes mellitus is a metabolic disorder marked by hyperglycemia and is primarily characterized by insulin resistance. Pharmaceutical treatments for this condition focus on increasing insulin levels to improve glycemic control which leads to a number of issues including weight gain, exacerbated insulin resistance, elevated leptin levels, and reduced adiponectin levels.

Intermittent fasting has gained popularity as a dietary approach aimed at enhancing body composition and metabolic health.

Intermittent fasting in Diabetes

Is Intermittent Fasting Safe for People with Diabetes?

Intermittent fasting refers to dietary patterns that focus on consuming very little to no calories for designated periods ranging from 12 hours to several days with a regular pattern.

Numerous studies suggest that intermittent fasting protocols may serve as a promising treatment for diabetes, improving various metabolic risk factors.

Research has found that with intermittent fasting:

There are significant reductions in fasting glucose levels.

Adiponectin levels increase while leptin levels decrease.

There are significant reductions in HbA1C and weight loss.

Prescribing Intermittent Fasting: Recommendations

Initial Symptoms: Patients may experience hunger and irritability when starting intermittent fasting, but these often decrease within 30 days.

Gradual Introduction: Begin with time-restricted feeding to ease the transition.

As patients adjust, the feeding window can be restricted further.

This approach allows patients daily flexibility in calorie consumption, enhancing compliance.

Risks in intermittent fasting

When considering intermittent fasting for patients with diabetes, several factors should be evaluated:

HYPOGLYCEMIA

Patients on insulin or sulfonylurea medications should be closely monitored to prevent hypoglycemic events.

As studies show a reduced need for insulin in patients who follow intermittent fasting protocols, physicians should closely monitor blood glucose levels and adjust medications as needed.

PROTEIN MALNUTRITION

Patients should be educated about the importance of consuming nutrient-dense meals and ensuring adequate protein intake during feeding periods.

VITAMIN AND MINERAL MALNUTRITION

It may be necessary to consider vitamin or mineral supplementation based on the patient’s dietary habits and the intended duration of the fasting regimen.

DEHYDRATION

Patients should be advised on the importance of maintaining adequate hydration during fasting periods, and the need to replace fluids typically obtained from food along with their regular daily requirements.

ADVERSE EVENTS

These may include dizziness, nausea, insomnia, syncope, falls, migraine, and excessive hunger pangs.

CONTRAINDICATIONS

These include pregnant or lactating women, older adults, individuals with immunodeficiencies, those experiencing hypoglycemic events, and patients with a history of eating disorders.

Conclusion

Diabetic patients interested in intermittent fasting should seek guidance from a healthcare professional. With proper adjustments to their medication and regular monitoring of blood glucose levels, intermittent fasting can be safely encouraged and effectively implemented for those with diabetes.

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