Is intermittent fasting recommended to diabetic people, and does it have any beneficial effects in the treatment of diabetes?

What is intermittent fasting ?

Intermittent fasting does not have an official definition. It generally consists of repeatedly alternating short periods of fasting with periods where one can eat without any restriction. Currently, no specific protocol exists regarding the duration and frequency of fasting periods.

What happens when you fast?

En temps normal, la principale source d’énergie du corps est le glucose (sucre). Celui-ci provient principalement des aliments que nous mangeons. Lorsque nous jeûnons, le corps n’a plus accès au glucose des aliments et doit ainsi trouver d’autres sources d’énergie. Il va alors puiser dans ses propres réserves, de gras principalement, pour fabriquer du glucose. La dégradation des gras entraîne la production de corps cétoniques. C’est, entre autres, ce mécanisme qui entraîneraient les bénéfices supposément attribués au jeûne intermittent.

If you are thinking of doing intermittent fasting, it is essential to discuss with your healthcare team, particularly if you have a prescribed diabetes medication.

What would be the benefits of intermittent fasting?

Effects observed on humans

Weight : this practice usually leads to weight loss, particularly when the periods of fasting last at least 24 hours. However, intermittent fasting does not always leads to a more significant weight loss than any other low-calorie diet.

Effects observed on mice

Body composition : intermittent fasting could preserve the muscle mass more than other low-calorie diet
Heart health : it is suggested that intermittent fasting could improve your blood pressure and cholesterol levels;
Aging : intermittent fasting could prevent age-related cognitive decline. Other studies are necessary to confirm this hypothesis.

Limitations of the studies

Lack of constancy between the types of fasting studied. There is currently no precise definition of intermittent fasting, making comparisons difficult.
Very little data on the long-term effects of intermittent fasting.
Difficulties to maintain intermittent fasting in the long term. Most people stop intermittent fasting after several months and therefore lose all the potential benefits linked to it.
Lack of studies on humans. The results mainly come from studies conducted solely on mice only and can not necessarily be applied to humans.

What would be the effects dof intermittent fasting on diabetes?

Intermittent fasting may improve the glycated hemoglobin (A1c), which reflects the average blood sugar level over the past two to three months. However, no significant difference in A1c has been observed when comparing intermittent fasting to other types of diet. This suggests that the observed effect may be attributed to weight loss rather than intermittent fasting itself.

Risk of hypoglycemia (low blood sugar)

Few studies on the subject have been conducted among people living with diabetes who are at risk of hypoglycemia. Special attention must be given to these people, as this practice could increase the risk of hypoglycemia. Close monitoring by a healthcare team and regular blood sugar checks are recommended.

Intermittent fasting and disordered eating

Extended periods of fasting can lead to extreme hunger, stress, frustration from food deprivation, and more. These could trigger obsessive behaviors and increase the risk of developing eating disorders.

In conclusion

While intermittent fasting appears to bring some benefits, these do not seem to surpass the results obtained with other low-calorie diets. Additionally, like all restrictive diets, it is unlikely to be sustainable in the long term. Considering the lack of human studies, adopting healthy eating habits and engaging in regular physical activity remain the most effective ways to improve one’s health.