The research is done on diabetic patients who practised fasting, and were observed to have better blood glucose management and a lower rate of fatality due to diabetes and its complications. 

Before we dive into the link between diabetes and intermittent fasting, let us know whether it is even recommended for diabetes patients to fast.

Should diabetic patients fast?

Diabetic patients are recommended across the globe to have regular meals since they take medication and are administered insulin which is to be taken only post a meal.

Let us understand the mechanism behind eating food and how it is affected by the levels of insulin.

What happens when we eat?

When we consume food, most of it is stored in the liver and the rest in the muscle. Insulin becomes the most active in our body when we consume food. Insulin plays an important role in regulating blood glucose, fat metabolism and water retention in the body. 

Since, the levels of insulin rise when we consume a meal, if the insulin in the blood is not utilised due to insulin resistance, the levels of insulin continue to stay high in the blood post the meal. 

A lesser-known fact about insulin is that it inhibits lipolysis or the burning of fat. Thus, the higher the insulin in our blood, the less the fat burning and the lower the insulin in the blood, the higher the fat burning. This is the reason fasting insulin is checked because as insulin levels decrease in the blood, it becomes easier to lose weight.

High levels of insulin in the blood cause –

1. Heart disease or Stroke

Researchers say that more than smoking, insulin resistance is the precursor of heart disease. 

2. High cholesterol

Since insulin promotes the storage of fat. High levels of insulin in the blood lead to the building of high cholesterol in the liver. 

3. High blood pressure

As insulin prevents lipolysis or fat breakdown, the fat is stored and reduces the diameter of the blood vessels causing high blood pressure.

4. Abdominal obesity

Higher the insulin levels in the blood due to insulin resistance, the higher will be the fat storage in the stomach or abdominal obesity.

5. Fatty liver

When diabetic patients are taken through a liver function test, 3 out of 10 patients run the risk of having a fatty liver grade 1 and grade 2.

6. Hormonal disorders

Since high insulin resistance leads to complications in regulating hormone levels in the body, disorders like PCOS and thyroid are directly linked to insulin resistance.

7. Acid reflux and sleep apnea

Once the insulin levels in the blood drop, patients have shown signs of improved sleep, reduced sleep apnea or pauses in sleep and reversal of acid reflux.

8. Alzheimers

Alzheimers is now known as type 3 diabetes since insulin resistance is known to adversely affect cognitive ability.

Due to the increased insulin levels in the blood or insulin resistance in diabetes, the best way to reduce insulin spikes in the body could be to reduce or pause food consumption which is the prerequisite for the production of insulin.

Intermittent fasting as the way forward –

To reduce glucose overload, reduce excess consumption of glucose in your body through a low carbohydrate diet. Grains are usually high in carbohydrates so it is important to minimise the foods rich in carbs and replace them with or increase the consumption of foods rich in fat, protein, vitamins and fibre.

In India, fasting has been a way of living for people across many states and religions since ancient times. 

What happens when we fast? – The mechanism behind intermittent fasting:

When we eat, the blood sugar spikes and insulin rises to increase the utilisation of glucose by the cells and convert glucose into glycogen.

↓

Post absorption – this stage lasts for 6 – 24 hours of practising intermittent fasting where the blood sugar levels drop and consequently the levels of insulin keep decreasing. The liver breaks down glycogen for releasing energy by breaking down glucose since glycogen is stored for 24-36 hours. 

↓

Gluconeogenesis: This begins 24 hours to 2 days of practising intermittent fasting and the liver starts making new glucose from amino acids.

↓

Ketosis: 2-3 days of practising intermittent fasting regularly, low levels of insulin are enough to break down fat for energy. This production of ketones from fatty acids enables the brain to utilise the ketones which make us feel energised and happier since the brain needs glucose or ketones to release endorphins.

↓

Protein Conservation phase: After 5 days of practising intermittent fasting, growth hormone levels increase by 5 times which maintains muscle mass and lean tissues. Energy is now supplied by ketones and the blood glucose levels are maintained by glycerol from the breakdown of fat.

Benefits of intermittent fasting –

• Burns excess fat in the body without affecting the muscle. Thus helping in healthy weight loss.
• Reduces over-eating
• Better mood and energy
• Decreased inflammation
• Improves insulin sensitivity
• Lowers insulin resistance
• Enhanced metabolism
• Improved immunity
• Better glucose and fat metabolism
• Better hormonal balance

Important to remember –

Although more research needs to be done on this front, it is observed that intermittent fasting can reduce the effects and even reverse type 2 diabetes. 

Since diabetic patients may experience fluctuation in levels of insulin and blood glucose levels, it is important to fast only under medical supervision.

Consult a physician to know which intermittent fasting schedule suits you the best, depending on your lifestyle and the type of diabetes.