Over the last few years, intermittent fasting has become an effective tool for weight loss, and with a lot of success stories around the globe, it’s no wonder experts promote it as an alternative and sustainable method for losing or maintaining weight. But IF doesn’t just benefit the physically conscious person, it also provides additional health advantages too. However, with this dietary pattern rising, people have wondered about its potential to treat lifestyle-related disorders. So today, we’ll look at what research has to say about intermittent fasting and diabetes.
In order to understand how far research has gone, let’s take a look at the basics of diabetes.
Warning: The information contained in this article is provided for informational purposes only. If affected by any medical condition, please seek the advice of your local physician.
How Diabetes Works
In normal healthy individuals, the pancreas is composed of alpha and beta cells, wherein the latter secrets insulin (a hormone responsible for storing sugar in the body). Once insulin is released (triggered by eating carbohydrates), it travels to the circulation and directs sugar molecules (particularly glucose) to the right places needed by the body (i.e. muscles, liver, and fat cells). However, in Diabetes, there is a dysfunction in this physiologic process.
Depending on the variant of the disease (i.e. Type I or Type II DM), insulin and beta cells are not working properly. In Type I DM, beta cells are destroyed, hence affecting insulin production, while in Type II DM, peripheral insulin resistance occurs (a condition where muscles shut down sugar absorption and the liver inappropriately releases glucose in the blood) together with decreased insulin secretion.
This cycle of increasing blood sugar and insulin resistance can, in turn, lead to fatigue, weight loss, recurrent vaginal infections, polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger) and other sympotms of DM.
Intermittent Fasting and Diabetes Reversal: What’s The Current Research?
The key reason for IF as a potential treatment for diabetes is based on the theory that fasting will decrease insulin resistance and somehow “reset” pancreatic cells in order to function optimally.
A number of studies were done on rodents to see the effects IF has on pancreas and insulin. For example, research done in 2017 divided mice into two groups: one fed at specific intervals (the IF group) and one allowed ad libitum feeding (eat without restriction) for 6 weeks.
Results showed these 3 key findings:
- Preservation of beta cells in the pancreas
- Regeneration of beta cells in the pancreas
- Improvement of glucose regulation
As a result, these suggest how IF can alter physiologic and anatomic improvements in healthy rodents. However, animal studies have their own limitations when it comes to humans. Hence it’s also important to look at human trials as well.
IF In Human Trials
Currently, studies in humans are very limited, with the majority focusing on non-diabetic related objectives such as lipid profile and weight loss. But thankfully, there are a few human trials that can help us draw a better picture of what might lie ahead in the future.
For instance, this study done by Harberg et. al on 8 healthy men who underwent intermittent fasting for 2 weeks shows how IF increases whole-body insulin sensitivity.
Another one was done in 2019 that looked at the effects of Alternate Day Fasting (ADF) and Daily Calorie Restriction (DCR) on insulin resistance for 12 months. Using 100 overweight people as the sample population, the study divided them into two groups, the IF group, and the DCR group. Results showed that those in the intermittent fasting group had decreased insulin resistance by more than 50% in 12 months compared to daily calorie restriction, which only decreased by 20%.
Sure, IF somehow appears to work (though the evidence is still limited) in healthy or prediabetic individuals. But what about among full-blown diabetics?
IIF In Diabetic Populations
There are 2 main studies done on diabetic populations as of today. The first one was done in 2016 among 63 overweight individuals with Type 2 Diabetes. Subjects were divided into two groups: one, following a 2-day fasting and 5 days of habitual eating (IF) while the other a continuous everyday restriction (CER) for 12 weeks. At the end of the study, scientists measured HbA1c (a standard test for measuring diabetic progression) of both groups, and noted a similar improvement both in the IF as well as CER group.
Another one was a case series done in 2018 with 3 diabetic patients (on insulin maintenance) who underwent alternate day fasting for less than 1 year under medical supervision. At the end of the study, all 3 patients managed to discontinue insulin, improved HbA1c, and decrease body weight — all without side effects.
So where does the evidence leave us?
After seeing how IF has the potential to heal pancreatic cells and improve insulin sensitivity, it might be tempting to assume that this approach can serve as an alternative treatment for diabetes. However, data is still limited, and more research is needed to strengthen the evidence before the medical community can use it as a new standard. As of now, IF is still at its early stage of research, hence, it’s not yet an approved gold standard treatment for diabetes. But suffice it to say, weight loss is an established method for improving DM markers, and intermittent fasting might be a good alternative over daily caloric restriction.
So whether you’re diabetic or not, if you’re planning on losing weight, always seek medical advice first to avoid worsening of underlying medical conditions. A lot of people end up making common IF mistakes, which highlights the importance of educating oneself first before trying this new approach.