Intermittent fasting has gained widespread popularity as a dietary strategy to improve metabolic health. It is often promoted for its benefits in enhancing insulin sensitivity, promoting weight loss, and lowering blood sugar levels. Several studies have shown that intermittent fasting can lead to significant reductions in HbA1c and body weight, particularly in individuals with type 2 diabetes. However, while the approach may be beneficial for some, it can also act as a double-edged sword for people living with diabetes if not followed carefully.
Potential benefits of intermittent fasting in diabetes:
- In selected individuals with type 2 diabetes, intermittent fasting can improve insulin sensitivity and help with weight reduction, both of which are crucial for better glycaemic control.
- Structured fasting periods may reduce overall calorie intake and improve metabolic flexibility, leading to lower fasting blood glucose levels and improved HbA1c over time.
- When done correctly and under medical supervision, intermittent fasting can be a useful adjunct to diabetes management.
Risks and challenges to consider:
When not done correctly, intermittent fasting can lead to both hypoglycaemia and hyperglycaemia in people with diabetes.
Despite its benefits, intermittent fasting carries potential risks for diabetics. One of the most significant concerns is hypoglycaemia, or low blood sugar, especially in individuals taking insulin or certain potent glucose-lowering medications. Long fasting hours without appropriate medication adjustments can dangerously lower blood glucose levels.
On the other hand, intermittent fasting may also lead to hyperglycaemia. After prolonged fasting, some individuals tend to overeat or consume meals high in refined carbohydrates and sugars, resulting in post-meal blood sugar spikes. This erratic eating pattern can counteract the intended metabolic benefits.
Importantly, intermittent fasting is not suitable for everyone. It may be unsafe for people with type 1 diabetes, pregnant or breastfeeding women, individuals with a history of eating disorders, or those with poor hypoglycaemia awareness. For these groups, fasting can pose serious health risks.
Importance of medical guidance and monitoring
Diabetics should follow the following precaution to practice intermittent fasting safely:
- Consulting a healthcare provider before starting intermittent fasting is crucial for diabetics.
- Medication dosages may need adjustment, and personalised guidance is essential to minimise risks.
- Regular blood sugar monitoring acts as a safety net, it helps detect hypoglycaemia early, assess how different foods affect glucose levels, and guide timely dietary or medication changes.
- Continuous glucose monitoring (CGM) can be particularly helpful, offering real-time insights and greater safety during fasting periods.
Conclusion:
Intermittent fasting can offer metabolic benefits for some people with diabetes, but it is not a one-size-fits-all solution. Without proper planning, monitoring, and medical supervision, it can backfire and lead to dangerous blood sugar fluctuations. A personalised, well-monitored approach is key to ensuring safety and effectiveness.
(Dr. Manisha Arora, Director - Internal Medicine at the CK Birla Hospital, Delhi)
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
