Science Update

New case report demonstrates beneficial effects of intermittent fasting on type 2 diabetes

Intermittent fasting has become increasingly popular the past few years to support weight loss, insulin resistance, and aging. However, there have been limited human clinical studies.

In a recent case report published in BMJ Case Reports, researchers demonstrated the effectiveness of intermittent fasting to reverse insulin resistance.

In this case report, 3 men between the ages of 40 to 67 in Toronto, Canada were able to reverse their insulin resistance resulting in the discontinuation of insulin injections while maintaining lower blood glucose levels following intermittent fasting. In addition, these patients lost significant amounts of weight, had decreased waist circumference and reduced their HbA1c levels.

All three of these men were taking numerous drugs in addition to insulin to manage their type 2 diabetes. They also all had hypertension and dyslipidemia.

Two of the men fasted on alternate days for a full 24 hours, whereas the third man fasted for three days per week. On fasting days, they were allowed to drink tea/coffee, water, broth, and to eat one very low calorie meal in the evening.

Prior to this therapeutic intermittent fasting program, they all attended a 6-hour long nutritional training seminar, which educated them on the pathophysiology of type 2 diabetes and its impact on the body as well as education on healthy eating and how to manage diabetes through diet, including therapeutic fasting.

All three patients followed this program for approximately 10 months. At this time a reassessment was performed including fasting blood glucose, HbA1c, weight, and waist circumference.

As a result, they were able to discontinue insulin injections within one month of starting intermittent fasting. One of the patients was able to stop insulin injections in just 5 days. In addition, two of the men were able to stop taking all their other diabetic drugs, while the third discontinued 3 of the 4 drugs he was taking. They all lost approximately 10 to 18% percent of their body weight as well as reduced their fasting glucose and HbA1c levels.

Perceived hunger is a common barrier to weight loss and can be an issue with compliance on an intermittent fasting diet. Some individuals may experience fatigue, dizziness, and irritability during this transition. In these cases, exogenous ketone supplementation can be used to decrease appetite and support weight loss.

Exogenous ketone supplementation increases blood ketone levels, which may directly suppress appetite as they lower plasma ghrelin levels and reduce cravings.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS


Source: Suleiman Furmli, Rami Elmasry, Megan Ramos, Jason Fung. Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin. BMJ Case Reports, 2018; bcr-2017-221854 DOI: 10.1136/bcr-2017-221854