Is intermittent fasting safe for diabetics? Suppose you are a diabetic who is interested in the intermittent fasting diet. In that case, this article will tell you about the potential risks involved with the diet and whether or not you should adjust your insulin levels if you plan on following it.

According to the Centers for Disease Control and Prevention, over 21% of adults aged 65 years and older have been diagnosed with diabetes. Nearly 25% of this age group injects insulin to help manage their diabetes, an illness in which the body cannot properly respond to or make insulin, a hormone needed to regulate sugar, starch, and other food’s absorption into the body’s cells for energy. If the cells cannot take in glucose, the level of the sugars in the body will rise, potentially leading to debilitating and life-threatening medical problems.

Intermittent fasting can help manage diabetes. People have been practicing fasting for thousands of years, sometimes for religious and spiritual reasons, but also as a means to maintain good health and to manage certain illnesses, including diabetes. But even with such a long history, researchers are only scratching the surface when it comes to understanding how intermittent fasting is impacting diseases such as diabetes.

Here we will talk in detail about the effects of fasting on blood sugar and whether intermittent fasting is safe or even okay for diabetics. So continue reading.

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Is intermittent fasting healthy and safe for diabetics?

The truth is that there is no one-size-fits-all answer to this question. Every person is different, and what works for one person may not work for another. So, Intermittent fasting can be healthy and safe for some diabetics but not others.

There is a lot of debate surrounding the topic of intermittent fasting, especially when it comes to whether or not it is safe for diabetics. Some people argue that intermittent fasting can help regulate blood sugar levels, while others contend that it can be dangerous for people with diabetes.

In contrast, the diet pattern of intermittent fasting is well-tolerated, aids weight loss, and does not cause hypoglycemia. These benefits make intermittent fasting a promising candidate for managing diabetes. Research on the benefits of intermittent fasting has increased, but researchers and health professionals are still hesitant to recommend it. This review summarizes the current findings on the impact of intermittent fasting in managing diabetes and provides evidence-based suggestions for the research and clinical care use of intermittent fasting.

There is increasing concern about the role of diet in disease prevention and potential intervention. Fasting has been recognized as an effective metabolic therapy due to its potential benefits in modulating cellular and biochemical reactions. This is particularly relevant for diabetes, a metabolic disorder characterized by high blood sugar levels due to defects in insulin secretion or action.

Key Points

Fasting as a Therapy: Recognized as a beneficial dietary strategy that can modulate cellular and biochemical processes to manage diabetes.
Unlike traditional diabetes treatments, focuses on the timing of eating and shows potential in reducing diabetes risk factors, although the exact pathways are not fully understood.
Caloric Restriction (CR): Involves reducing daily calorie intake by about 30% while maintaining essential nutrients and has shown benefits similar to those of fasting.
Health Benefits: Both calorie restriction and intermittent fasting may improve pancreatic function and glycemic stability, contributing to better management of metabolic diseases like diabetes and obesity.
Different Fasting Protocols: Popular IF protocols include reducing calorie intake by two-thirds on certain days or limiting eating to a 6-10 hour window each day.

Benefits of Intermittent Fasting For Diabetics With Type 2

Even though there are many health risks for diabetics to fast for a long time, there are also some advantages that include:

Controlling blood sugar levels

The most significant advantage of intermittent fasting is that it can help to control blood sugar levels.

Studies have shown that people with diabetes who fast intermittently (meaning they eat small meals throughout the day rather than one large meal) tend to have better blood sugar control than those who don’t fast at all.

This is because intermittent fasting allows your body to switch from using glucose for energy to burning stored fat.

Intermittent fasting for diabetes weight loss

Intermittent fasting can also help to promote weight loss.
This is because when you fast, your body signals your brain to burn more calories.

So if you are a diabetic and want to try the intermittent fasting diet, it is important to discuss the risks and benefits with your doctor first.

However, it’s important to note that intermittent fasting is not for everyone with diabetes. If you have serious blood sugar problems, then you should avoid fasting altogether.

Inflammation and Oxidative Stress

Inflammation and oxidative stress play crucial roles in diabetes and related metabolic disorders. Energy metabolism from ketosis, achieved through fasting, can significantly impact weight loss and overall metabolic health. Regular fasting routines, such as intermittent fasting (IF), can help manage fasting glucose levels and reduce the severity of aging-associated diseases like cancer.

Ketosis and Energy Metabolism: Ketosis from overnight fasting can be maximized during prolonged fasting, leading to efficient weight loss and metabolic benefits.
Intermittent Fasting (IF): Regular fasting coupled with controlled calorie intake on weekends promotes consistent weight loss and metabolic health.
Managing Dysmetabolism: Proper fasting glucose management can reduce the severity of metabolic disorders (obesity, insulin resistance, dyslipidemia) and decrease overall mortality.
Daily Eating Patterns: Typical daily meals, especially high-carb breakfasts, increase glucose and insulin levels, contributing to weight gain and metabolic issues.
Role of Adipokines: In obese and type 2 diabetic individuals, inflammation is linked to visceral fat, which secretes pro-inflammatory hormones. This increases insulin resistance and chronic hyperglycemia.
Inflammation and Oxidative Stress: These processes are central to long-term vascular complications in diabetes, driven by pro-inflammatory cytokines from fat tissue.
Aging and Mitochondrial Function: Aging diminishes mitochondrial function, leading to oxidative stress, abnormal protein accumulation, and reduced insulin response, contributing to diabetes.
Prediabetes Diagnosis: Elevated oxidative stress markers in red blood cell lipids can help identify prediabetes using oral glucose tolerance testing.

Practical Tips for Implementing Intermittent Fasting in Diabetes Care

As of 2015, 415 million adults worldwide had diabetes, and diabetes was projected to be the seventh leading cause of death by 2030. Poor management of diabetes is associated with a variety of life-threatening complications. Intermittent fasting is an underutilized tool that can be considered in managing diabetes.

Here, we review the evidence base supporting this, discuss the factors that should be considered when implementing intermittent fasting, and provide practical tips for dietitians and healthcare providers managing patients with diabetes. With the information provided, dietitians will be able to share how these strategies safely impact diabetes-related outcomes.

Consultation with Healthcare Providers

Moreover, a range of severe adverse events have been associated with intermittent fasting, especially when performed without expert advice at the onset. Each citizen should be encouraged to check in with a healthcare provider, whether a doctor, a dietitian, or a nurse, before and during the practice of an intermittent fasting regimen.

Two model tools have been designed to encourage a dialogue between healthcare professionals and patients. These model tools are a twelve-item checklist that has been conceived to promote a close exchange between the patient and the healthcare professional when designing the desired intermittent fasting strategy and a patient-centered decision aid tool showing the expected benefits of such a strategy.

The American Diabetes Association (ADA) Standards of Medical Care in Diabetes recommend that any individual who begins an intermittent fasting diet or who experiences changes or problems with their health during the practice of an intermittent fasting regimen be referred to a registered dietitian or another qualified nutrition expert who can provide an individualized and safe eating plan.

Healthcare providers should always be aware of potential negative impacts on an individual’s or a group’s health and working capacity and take measures to minimize risks responsibly.

Good communication between patients and health professionals is imperative to guide the safe and effective use of the medications available for the management of diabetes. In addition, good communication with other members of the public health team (e.g. dietitians, podiatrists, etc.) is critical.

Adjusting Medication and Monitoring

The individual will know best what sort of treatment regimen is suitable. It should be noted that the concept of the “half-serve hypo” is central to the day of fasting model, where small serves of food are eaten at each meal. The second issue is the changing of the ingrained food eating pattern that the “three meals a day” advice has resulted in over time. One way around changing dietary habits is simply to move the meals 8 hours later.

This way, the only time that eating is omitted is when sleeping. This particular approach seems to offer comfort to individuals who suffer most of their blood glucose problems overnight, regularly waking up in the night feeling unwell, and having dreamt only of food. 8 hours is not magic.

There are a few basic issues that need to be resolved before one embarks on intermittent fasting. The first is medication. For some people, endocrinologists will simply cut the dose of their medications and advise daily monitoring of blood glucose during the first fortnight, so that appropriate listening to the body signals will be possible.

Medication can be scaled back and progressive fasting can be expected to have a higher fat: protein: carbohydrate ratio, making a lower dose appropriate. When dealing with people with a history of eating disorders, approaching intermittent fasting can be quite challenging.

Meal Planning and Nutritional Balance

Some researchers argue that the primary quality measure for people with diabetes should be whether fat calories are replaced with calories from carbohydrates that are beneficial for health, such as whole grains, legumes, vegetables, fruits, and fiber. Research from large trials also shows that limiting saturated and trans-unsaturated fat intake is important for preventing cardiovascular disease, whether people have diabetes or not.

Since some weight loss is desirable for many people with type 2 diabetes, or at least maintenance of body weight, a diet lower in calories may influence food choices and amounts, which will help achieve the desired dietary composition. Eating limited amounts of fat, and fatty acids can be taken as a dietary supplement to promote nutrient adequacy.

There are two main approaches to diabetic diets:

Timing of Meals:

An approach that focuses on the timing of meals called meal planning, or nutrient balance in which diabetic patients should eat a variety of nutrient-dense foods to get all the nutrients with as few calories as possible.

Classic meal planning:

These methods traditionally distribute the total daily calories and the calories from carbohydrates, protein, and fat evenly throughout meals of the day. This method is widely accepted by researchers in the field of diet and diabetes.

However, there are some other meal-planning methods, such as eating carbohydrates and protein at a lower glycemic index (GI) and not eating high-fat foods.

Does intermittent fasting have negative effects on diabetics?

One interesting study was done to try and determine whether or not intermittent fasting affects diabetics’ health negatively. The study was about “Habituation of food intake with intermittent fasting .”

In this study, they found that the glucagon-like peptide-1 (GLP-1) increased in the bloodstream of the study participants after 10 days of being on an intermittent fasting diet.
GLP-1 stimulates insulin secretion and is, therefore, a very important hormone for controlling blood sugar levels.
When a study was done to determine the glycemic index of five different types of meals that were eaten on alternate days. They found that the glucagon-like peptide-1 (GLP-1) became active only when participants ate on alternating days.
Other studies showed that an intermittent fasting diet can improve insulin sensitivity in diabetics as well as reduce their blood sugar levels by as much as 30% after 12 weeks. A study done in 2006 found that the non-diabetic subjects taking part in an intermittent fasting diet significantly reduced their insulin requirements by as much as 36% over 12 weeks.

Can a diabetic fast for 24 hours?

A diabetic can fast for 24 hours but should speak to a doctor before doing so. If you are diabetic you need to monitor blood sugar levels and this type of fasting can increase your risk of developing low blood sugar.

Unfortunately, fasting can have several negative effects on diabetics, like:

Trying to fast for a long time (24 hours) can make you experience tiredness and weakness.
Countering the ability to control blood sugar, especially if you depend on insulin to manage your blood sugar levels.
In people with type 2 diabetes, IF increases the risk of hypoglycemia. People on certain diabetic medications, such as insulin, may be at a higher risk of this potentially fatal complication.

Does a low-carb diet cause low blood sugar?

Low-carb diets in general can lower blood sugar levels drastically due to the lack of carbohydrates. In a short period, low-carb diets can have dangerous effects on people with diabetes who are taking insulin. The risk of developing low blood sugar should be monitored by a doctor especially if you are following a particular diet.

However, if you are diabetic, you should consult your doctor about following a low-carb or intermittent fasting diet.

Check out Atkins low carb diet.

Metformin and intermittent fasting

These days metformin and intermittent fasting are two popular methods for weight loss. Metformin is a medication that helps to lower blood sugar levels. Intermittent fasting is an eating pattern where you cycle between periods of eating and fasting.

The problem with metformin and intermittent fasting is that to lose weight, your body has to be continually starved of carbohydrates.

For example, in the case of metformin, you have to take the medication continuously so that your body is always starving of carbohydrates. This can cause extreme weakness and lethargy.

Your body might not show any change if you are taking this medication, so if you do start it, you might be taking it for some time before you realize that it is not working.

In the case of intermittent fasting, if you do not eat anything for a long period, then it is very easy to become weak and lethargic because your body does not have food to fuel it. Intermittent fasting can make you feel weak, lethargic, and unhealthy.

Will fasting for short periods raise blood sugar?

No, fasting for short periods, especially if you’re healthy and don’t have any underlying medical conditions like diabetes, typically doesn’t raise blood sugar levels.

Short-term fasting can lower blood sugar levels, as your body utilizes stored glucose for energy when you’re not consuming food.

During fasting, especially in the initial hours, your body relies on glycogen stores in the liver and muscles for energy. Once these glycogen stores are depleted, your body may start breaking down fat stores for energy through a process called ketosis. This can lead to a decrease in blood sugar levels.

However, it’s important to note that if you have diabetes or other metabolic disorders, fasting can affect blood sugar levels differently. Individuals with diabetes, especially those on certain medications like insulin or sulfonylureas, may experience fluctuations in blood sugar levels during fasting and should consult with their healthcare provider before fasting.

Additionally, prolonged fasting or fasting for individuals with certain medical conditions may lead to other metabolic changes that could affect blood sugar levels. Always consult with a healthcare professional before making significant changes to your diet or fasting regimen, especially if you have any underlying health concerns.

Is Intermittent Fasting Safe For Diabetics?