Can Intermittent Fasting Help Patients Live with Diabetes?

Studies are showing that intermittent fasting may help patients better manage their diabetes and reduce their insulin intake. 

In recent years, intermittent fasting has gained a great deal of attention, with many people attributing their weight loss to intermittent fasting. Intermittent fasting is when you consume your food within a specific time window and fast for the remaining hours. There are many different intermittent fasting schedules. Some of the most popular are the 16:8, the 20:4, and alternate-day fasting. In the 16:8 and 20:4, an individual would only eat during the 8- or 4-hour window and fast during the 16- or 20-hour window. During alternate day fasting, a person would eat for 24 hours and fast for 24 hours.  

It is a well-known fact that obesity is one of the leading causes of diabetes. The fat tissues in the body secrete cytokines known as adipokines. There are two types of adipokines, pro-inflammatory and anti-inflammatory. The pro-inflammatory adipokines are called leptin and can lead to chronic inflammation. Leptin is responsible for controlling body weight. People with a high body mass index and increased insulin resistance had more elevated amounts of leptin in their bodies. The anti-inflammatory adipokines are called adiponectin. Adiponectin has antidiabetic properties and the opposite effect of leptin on the human body. While leptin seems to relate to body fat directly, adiponectin has an inverse association with body fat. When a patient’s body fat increases, adiponectin decreases.  

Where does intermittent fasting come into play? Research shows that people who engage in intermittent fasting have increased adiponectin levels and decreased leptin levels in the body, which can help those struggling with insulin resistance. While overall reduction in calories can achieve weight loss, a calorie deficit is hard to maintain for most individuals. Intermittent fasting has a higher success rate than a reduction in dietary calories. Intermittent fasting also shows metabolic and weight loss benefits in people who implement it. These positive effects are due to the body’s shift in energy sources from glucose to ketones and fatty acids. 

Base on their review of PubMed, Ovid MEDLINE, and Google Scholar databases for review articles, clinical trials, and case series related to type 2 diabetes, insulin resistance, and intermittent fasting, the researchers conclude that intermittent fasting is effective at reducing body weight, decreasing fasting glucose, decreasing fasting insulin, reducing insulin resistance, decreasing levels of leptin, and increasing levels of adiponectin. Some studies have found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician. 

Intermittent fasting could be a very effective way to help individuals manage their diabetes. Before attempting to begin intermittent fasting, patients should contact their doctor to make sure they can safely implement. It is advisable for patients to start slow, gradually decreasing the eating window and increasing the fasting window. A good place to start would be 12 hours of eating and 12 hours of fasting. From there, an individual can progress to 8 hours of eating and 16 hours of fasting, and so forth.  

Practice Pearls: 

• Intermittent fasting is the practice of eating all of your meals during a specific window of time throughout the day and fasting for the remaining timeframe. Some popular timeframes include 16:8 and 20:4. 
• Intermittent fasting reduces leptin and increases adiponectin in the body. It also helps to decrease insulin resistance. 
• It is imperative that any patient with diabetes who wants to implement intermittent fasting contact their doctor first, to ensure intermittent fasting is right for them. 

Albosta, Michael, Jesse Bakke. “Intermittent Fasting: Is There a Role in the Treatment of Diabetes” Clinical Diabetes and Endocrinology, BMC Medicine, February 3, 2021,  

National Diabetes Statistics Report. CDC.gov: U.S. Department of Health and Human Services; 2020. 

Oluwatayo Ishola, PharmD. Candidate, South College, School of Pharmacy