Risk factors

Intermittent fasting may help reverse type 2 diabetes and stop insulin

Medically-supervised intermittent fasting may help to reverse type 2 diabetes, according to Canadian doctors who have published a case series covering three of their patients who were able to stop using insulin.

Writing in the journal BMJ Case Reports they says three men, aged between 40 and 67, undertook medically supervised ‘therapeutic fasting’ for 10 months when they had T2D managed with insulin and other diabetes drugs.

During fasting periods, patients were allowed to drink unlimited amounts of very low-calorie fluids such as water, coffee, tea and bone broth. Precise fasting schedules varied depending on the patient’s preference, ranging from 16 hours to several days.

Before embarking on their fasting regime, the men all attended a 6-hour long nutritional training seminar, which included information on how diabetes develops and its impact on the body; insulin resistance; healthy eating; and how to manage diabetes through diet, including therapeutic fasting.

Two of the men fasted on alternate days for a full 24 hours, while the third fasted for three days a week. On fast days they were allowed to drink very low calorie drinks, such as tea/coffee, water or broth, and to eat one very low calorie meal in the evening.

Within a month of starting their fasting schedule all three men were able to stop insulin, in one case this took only five days.

Two of the men were able to stop taking other diabetes drugs, such as metformin. They all lost around 10-18% of body weight and reduced waist circumference by around 10cm.

After intermittent dieting the three men were also able to reducing their HbA1c levels from 11 to 7, 7.2 to 6 and 6.8 to 6.2% respectively.

The men had medical review every two week and feedback was positive, with all three managing to stick to their dietary schedule without too much difficulty.

The report authors said that despite the recommendations for weight loss as a means of managing type 2 diabetes, there were virtually no literature reports of the effects of intermittent dieting.

“This present case series showed that 24-hour fasting regimens can significantly reverse or eliminate the need for diabetic medication.

Such an approach may be particularly attractive for people with T2D who have difficulty using insulin or who have adverse effects such as from antidiabetes medications such as metformin, they suggested.

“Fasting is a practical dietary strategy. With proper education and support, we found compliance to be good,” wrote the authors from the Department of Family Medicine at the university of Toronto.

“Therapeutic fasting is an underutilised dietary intervention that can provide superior blood glucose reduction compared with standard pharmacological agents,” they concluded.

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