Could Intermittent Fasting Help People Ditch Diabetes Meds?

Dec 15, 2022 – Some people with type 2 diabetes may be able to lose weight, lower their blood sugar, and stop taking diabetes drugs, if they follow anintermittent fasting diet for 3 months, new research suggests.

Intermittent fasting – such as the 5:2 diet, which consists of eating few calories for 2 days followed by eating normally for 5 days – has led to weight loss in previous studies.

But it hasn’t been clear whether intermittent fasting might lower HbA1c levels – a measure of a person’s average blood sugar levels over the past 2 to 3 months.

And specifically, it was not known if intermittent fasting could let people revert to a non-diabetic state, known as diabetes remission – defined as having a blood sugar level below 6.5% for at least 3 months after stopping all diabetes medications. 

This new study in 72 patients with type 2 diabetes in China showed that indeed, the 36 patients in the intermittent fasting group lost roughly 13 pounds and maintained this weight loss for 1 year, and close to half achieved diabetes remission. This compared with barely any weight loss for the 36 patients in the control group, of whom just 3% achieved remission.

The results show that “type 2 diabetes is not necessarily a permanent, lifelong disease,” senior author Dongbo Liu, PhD, from the Hunan Agricultural University in China, said in a news release. “Diabetes remission is possible if patients lose weight by changing their diet and exercise habits.”

“The large amount of weight reduction is key to continuing to achieve diabetes remission,” Amy E. Rothberg, MD, PhD, a professor of nutritional sciences at the University of Michigan, said in an interview. Rothberg was not involved with this study.

The bottom line is that “lifestyle changes work,” she says.

Although these findings are specific for an Asian population, they suggest that a similar approach could be tailored to other populations.

People with type 2 diabetes who would like to try intermittent fasting need guidance from a dietitian, Rothberg says, to make sure their diet includes all the necessary micronutrients, vitamins, and minerals on fasting days. They also need to maintain a relatively balanced diet and not gorge themselves on feast days. 

She also advises patients: “Try to reduce your calories by a method that you find sustainable, so that you can lose weight and maintain that reduced weight.” 

The study was published Dec. 14 in The Journal of Clinical Endocrinology & Metabolism.