On Intermittent Fasting and Diabetes

When it comes to learning about type 2 diabetes and related subjects, it just never ends. That’s not a complaint; on the contrary it’s a good thing. I’ve come to the decision awhile back; this is a lifelong process for me, researching and learning. After all, as a type 2 diabetic, my life depends on it. Which is why when I kept coming across the term intermittent fasting (IF) my interest was aroused.

At some point, I came across You Tube videos of Dr. Jason Fung and he speaks about this topic. Fasting is one of his tools in treating type 2 diabetes naturally. In fact, he is one of the 40 speakers at the online and free 2015 Diabetes World Summit. I’m looking forward to him and several others. You should check him out. You can register for free, just click on the link in the previous sentence.

What is Intermittent Fasting

In essence, intermittent fasting, in Brad Pilon’s written words in Eat Stop Eat is; “The act of willingly abstaining from some or all food, and in some cases drink, for a pre-determined period of time.” The concept of this way of fasting is built on the foundational principle that the body, in dietary or metabolic terms can only be in one of two states: fed or fasted.

The fed state includes the time during which we are eating and immediately thereafter for up to 3-5 hours when insulin is present. Now the fact that insulin is present means that the body is absorbing nutrients because it is a storage hormone.

This absorption period can extend several hours beyond that initial window but it progressively diminishes. At the same time, we are working our way into the fasted state. Let’s call this stage the post-absorption state. It can last 8-12+ hours from the time you finished eating your last meal.

Nonetheless, by hour 12 you’re in the fasted state and reaping the benefits of a fast. The key is to extend the 12 hours as long as reasonably possible. But what makes this intermittent is that you typically would not exceed something like 24 hours even though by this time, you’re fully utilizing fat reserves for energy.

Intermittent Fasting Benefits

This list is all-inclusive in terms of how it affects both diabetics and non-diabetics alike. In the following section, I will address diabetes specific considerations. IF has these wonderful benefits:

  • Low to non-existent insulin levels
  • Decreases body fat
  • Improves cardiovascular health
  • Lowers chronic systemic inflammation
  • Protects and maintains skeletal muscle
  • Autophagy – cellular detoxification and rejuvenation
  • Increases insulin sensitivity
  • Reduces oxidative stress (from eating)
  • Decreased liver glycogen (stored sugar)

For Diabetics

The benefits I listed above apply to all of us diabetics as well; after all we’re human. However, of particular importance for us are the low to non-existent levels of insulin floating in our bloodstream while fasting especially in the later hours. Since we’re not eating, the pancreas does not secrete insulin, as it doesn’t need to. Why is this important?

If you’re a type 2 diabetic, hopefully you understand that we became so due to the sustained high levels of the hormone. Over the years, this led to insulin resistance, which then led to the high blood sugars we experience today. Drastically reduce insulin exposure and over time you alleviate the insulin resistance, the source of T2D.

High blood sugars are only a symptom and unfortunately, it is this that the medical establishment treats even though there is a wealth of research concluding that this is not the most effective way to treat it. At the very least, it is not the source that they treat, only the symptom.

I almost got too ahead of myself and forgot to ask: How or why do we develop high levels of insulin in the first place? One word: FOOD! The sustained over consumption of food, more specifically carbohydrates and processed foods led us on that path. Every time we eat, carbs and or protein, we release insulin. The constant eating over time, led to the resistance.

If food was the catalyst for our insulin resistance then what will help correct it or at the very least improve it? One word: FOOD! The absence of FOOD, right? Make sense? And how do we implement this? Two words: Intermittent Fasting! I got excited writing this paragraph. Powerful stuff. It makes complete logical sense, well to me at least but I do hope to you as well.

As for type 1 diabetes, we know that a T1D’s pancreas does not produce insulin or very little at best. They don’t suffer from insulin resistance since they don’t produce it. But what I’ve read in forums is that IF will help lower the amount of insulin they need to inject, if they’re also following a very low carb way of eating. Again, this makes complete logical sense to me.

But the number one caveat I have to make you aware of is if you’re on medications that cause hypoglycemia or low blood sugars you need to be extremely careful. My understanding is that not all meds do this and one type of medication can have different effects on two different people. Only you would know. I’m not using meds so I don’t run into hypos as they’re called too.

All that being said, you need to consult your doctor about this if you’re interested in intermittent fasting. I for one am convinced it’s an extremely positive thing. I mean, heck, reread that list above. Enough said.

Another point I’ll make is that many doctors, quite frankly, aren’t educated about alternative ways to treat a disorder like type 2 diabetes. In type 1, the only effective treatment is insulin injections. But T2D is metabolic or having to do with metabolism, nutrition and digestion. Do they teach that in medical school?

I bring this up because in a case like this, a doctor or your registered dietitian may not be knowledgeable in these areas. They stick with protocols and treatments that judging by the alarming growth in worldwide diabetes, ultimately exhibit little success, and may even discourage you from trying intermittent fasting. The same applies with lowering your blood sugar with a low carb high fat (LCHF) diet.

My response to that is, ultimately we are responsible for ourselves and although our relationships with our doctors are a partnership, we make the executive or final decisions. Their job is to help us make informed decisions, assuming they have the appropriate knowledge. That is also how I see myself with this blog and specifically this post; to give you the information you need to make an informed decision.

Before I go on to the next section, in terms of this intermittent fasting, if you decide to give it a try then you want your doctor’s assistance in helping you manage the medications to mitigate the low blood sugar episodes. That should be your objective.

The last consideration for diabetics is having your diet dialed in to the point where your blood sugars are not exceedingly high all the time. Before I went low carb high fat and ketogenic, I was all too familiar with the ravenous hunger present around the clock unless I was indulging in food, specifically carbohydrates. It’s a vicious cycle you don’t really want to be caught up in while trying out intermittent fasting. The stress can be too hard and may set you up for failure. This cycle needs to be broken regardless of trying out IF or not.

Getting Started

In Eat Stop Eat, author Brad Pilon advises you to fast for 24 hours 1 to 2 times a week, separated by 2-6 days in between fasts for recovery. So that you don’t go one day without a meal, on any given day, have a meal, let’s say at 1 pm. This is the time you are done eating the meal. Your fast would end with a meal at 1 pm the next day. Twenty-four hours would have elapsed and you gained benefits. You can insert the best time that works for you and your schedule. If you were to do another fast in the same week, wait at least 48 hours.

Another way to implement IF is using a 16/8 daily split. This is 16 hours fasting with an 8 hour feed window. Some people use this on a daily basis like James Clear. He has a good article, which you can read here. Do note that he doesn’t address diabetes.

Simply, you would count 16 hours from the time you finished eating your last meal, after which, you would have your break-fast meal. Then you eat normally for the next 8 hours. I like the flexibility in this method because it can be tailored to your schedule. It is also perceivably easier to use while starting out; 16 hours compared to 24.

A great way to start testing the waters with intermittent fasting is to extend your overnight fast. What I mean is, essentially, you extend the time until you have breakfast after rolling out of bed. For example, have an early dinner. This is something you should be doing anyway so that you don’t take your dinner’s blood sugar to bed. That’s a few hours right there. Now add on sleep time and you have a few more hours. Upon waking, you wait to have breakfast. You can use this progressively and before you know it, you could be at 16 hours.

You can have the following but without sweeteners so you don’t create a glucose and insulin spike, effectively terminating the fast.

  • Black coffee
  • Black tea
  • Green tea
  • Herbal tea
  • Water
  • Sparkling water

My Experience

As of this writing, I’ve fasted for 24 hours about 3 times in the last 2 months. Also, I’ve fasted for 16 hours about 4 times during the same time period. However, to truly and fully reap the benefits, intermittent fasting should be done on a regular schedule for some length of time. This is what I’ve gathered from the sources I’ve read. Nonetheless, I believe we’re gaining a benefit any time we fast. At the very least, we’re burning fat for energy and avoiding insulin and glycemic spikes.

Fasting can be physiologically and psychologically tough at first but it gets better. And honestly it’s not as tough as it may seem. You do feel hunger acutely for short periods of time but this alternates with periods of energy and mental clarity, which I love and worth the price of admission. You have to try it for yourself.

Blood Sugars

In terms of my blood sugar levels during these fasts, in the very beginning I noticed no change from what I was used to seeing. But afterwards they tend to stay flat which, is actually good. No matter how low my blood glucose is during the day and when I go to sleep, it’s always higher when I get up in the mornings due to the dawn phenomenon effect. So for me to wake up to about the same levels I went to bed with is highly encouraging.

I can only imagine what sustaining these fasts over time will do for you and me. I am working towards that end will report back with a post in a few months. I surely didn’t want to wait for then to publish this information. Be one of the first to know when I publish content by filling out the short web form below. Be sure to confirm your subscription so you won’t miss out.

Take care and until next time.