Intermittent fasting could be a safe and feasible dietary option for improving glycemic control in insulin-treated people with type 2 diabetes.
The prevalence of type 2 diabetes is rising globally, making it essential to explore various dietary modifications to manage blood glucose levels, weight, and cardiovascular risk factors. Intermittent fasting (IF) has emerged as a potential alternative to traditional daily caloric reduction methods. The different approaches to IF include restricting food intake to certain hours of the day or alternating between fasting and eating days. Individuals with insulin-treated type 2 diabetes often struggle with weight gain, leading to a vicious cycle of increasing insulin doses to combat insulin resistance, further weight gain, and higher cardiovascular risk. IF offers a promising approach to managing weight and improving insulin sensitivity, potentially breaking this cycle. IF could be an accessible and cost-effective intervention to improve the health outcomes of people with type 2 diabetes.
A randomized controlled trial published in the journal Diabetes Care reported that IF is a viable and secure dietary approach to enhance glycemic control and reduce the total daily insulin dose and body weight in individuals with type 2 diabetes who are already receiving insulin therapy.
Improved Glycemic Control
After 12 weeks of intervention, the IF group showed a significant decrease in HbA1c levels, whereas the control group experienced an increase in HbA1c levels. The difference in the change in HbA1c levels between the IF and control group was statistically significant, even after adjusting for age, sex, diabetes duration, and baseline HbA1c.
Reduced Insulin Dose and Body Weight
The IF group also showed a reduction in total daily insulin dose and body weight after 12 weeks compared to the control group. This reduction in insulin dose and body weight was achieved without compromising glycemic control.
Increased Adherence to Fasting Protocol
Of the 22 participants in the IF group, 20 achieved more than 75% adherence to the given fasting protocol. This demonstrates that IF is a feasible intervention that can be successfully adhered to by most participants.
Five serious adverse events leading to hospitalization were reported during the study period, but none were related to the study intervention. This suggests that IF is a safe intervention for people with type 2 diabetes.
Promoted Beneficial Metabolic Changes
The study also found that acetic acid, dimethylsulfone, and some ketone bodies significantly increased in fasting individuals. This suggests that fasting triggers specific metabolic changes that could contribute to the observed benefits of IF for managing type 2 diabetes.
It is concluded that IF could be a promising intervention for managing type 2 diabetes, as it has been found to improve glycemic control, reduce insulin dose and body weight, and improve adherence to a fasting protocol. This study also found that IFwas safe and well-tolerated by participants. However, further research is needed to explore the long-term effects of IF on type 2 diabetes management and to determine the optimal fasting protocol for different individuals.
Obermayer, A., Tripolt, N. J., Pferschy, P. N., Kojzar, H., Aziz, F., Müller, A., Schauer, M., Oulhaj, A., Aberer, F., Sourij, C., Habisch, H., Madl, T., Pieber, T., Obermayer-Pietsch, B., Stadlbauer, V., & Sourij, H. (2023). Efficacy and Safety of Intermittent Fasting in People With Insulin-Treated Type 2 Diabetes (INTERFAST-2)-A Randomized Controlled Trial. Diabetes Care, 46(2), 463-468. https://doi.org/10.2337/dc22-1622