Diabetes is a chronic disease that affects how your body uses glucose, which serves as the primary source of energy. When you have diabetes, your body either produces insufficient insulin or is unable to utilise it efficiently, which can result in elevated blood sugar levels.
Diabetes is a significant public health issue in Singapore, affecting an estimated 34% of the population aged 50 – 59 years old, according to the 2020 National Population Health Survey. It is one of the top 10 principal causes of death in 2019 – 2020 at 1.2% and down to 1.1% in 2021. It is also a major contributor to other health problems such as heart disease, kidney disease, and blindness.
Fortunately, there are a variety of ways to manage diabetes, one of which is a controlled diet. This article explores how intermittent fasting could be incorporated into a comprehensive diabetes management plan, and if it’s the right step for you.
When you intermittently fast, you limit the amount of food you eat to periods of time, which can be anywhere from a few hours to a few days. The 16/8 method, the 5:2 diet, the eat-stop-eat method (sometimes known as the "24-hour fast"), and alternate-day fasting are a few examples of intermittent fasting diets.
In contrast to the 5:2 diet, which calls for eating regularly for 5 days before capping calories at 500 – 600 on 2 separate days, the 16/8 technique calls for fasting for 16 hours and eating within an 8-hour window. Alternate-day fasting alternates between days when you eat normally and days when you fast, while the eat-stop-eat approach, or "24-hour fast", entails fully forgoing meals for 1 or 2 days that are not consecutive in a week.
It should be emphasised that intermittent fasting may not be appropriate for all people with diabetes and is not a one-size-fits-all method of managing the condition. That said, it can be a useful tool when used in a comprehensive diabetes management plan.
The first benefit of intermittent fasting is better blood sugar regulation. Blood sugar levels have been demonstrated to be improved by intermittent fasting. Intermittent fasting helps to control the release of glucose into the bloodstream, which can lead to reduced fasting blood sugar levels by limiting meal intake to specified times. In persons with type 2 diabetes, intermittent fasting has been proven to lower fasting glucose levels by 5.6%.
Also, it has been found that fasting increases insulin sensitivity, or the body's capacity to react to insulin and efficiently use glucose. A study published in Diabetes Care found that intermittent fasting improved insulin sensitivity and reduced insulin levels in people with prediabetes.
This brings up a further advantage of intermittent fasting – it can aid in the control of prediabetes. Prediabetes is a condition that occurs when blood sugar levels are above normal but not high enough to be classified as type 2 diabetes. Since intermittent fasting can improve blood sugar control and insulin sensitivity, it can help prevent or delay the onset of type 2 diabetes in some people with prediabetes.
In addition to managing prediabetes, intermittent fasting has been shown to assist weight loss by lowering intake of calories and boosting metabolism. According to the Ministry of Health, 36.2% of adults in Singapore are overweight or obese, which increases their risk of developing type 2 diabetes.
When someone with type 2 diabetes loses a moderate amount of weight through a combination of intermittent fasting and physical activity, their condition can be better controlled, and further complications delayed. Weight loss also aids in better blood sugar regulation, which is crucial for managing diabetes.
However, as mentioned above, practising intermittent fasting might not be suitable for everyone with diabetes, and there are some potential downsides to adopting this diet.
Some people could find it difficult to follow a tight eating schedule and might struggle with hunger, fatigue, and other symptoms when fasting. It's crucial to pay attention to your body's signals and modify as necessary. It is advised to begin cautiously and to gradually lengthen your fasting times over time if you are new to intermittent fasting.
Individuals with certain medical conditions, such as liver or kidney disease, should not follow an intermittent fasting diet without consulting with their doctor first. Also, intermittent fasting might cause hypoglycemia and hyperglycemia in people with diabetes. Hypoglycemia, or low blood sugar, can occur if you take diabetes medication and do not eat enough food during your eating window. Hyperglycemia, or high blood sugar, can occur if you overeat during your eating window or do not take your diabetes medication as prescribed.
Before adopting intermittent fasting for diabetes, it is important to consult a doctor or registered dietitian. They can assist you in creating a strategy that is specific to your requirements and in determining whether intermittent fasting is right for you.
In addition to intermittent fasting, it's critical to maintain a healthy diet, get regular exercise, and use any prescribed medications to treat diabetes. The risk of problems related to diabetes can be decreased by making lifestyle changes, such as dietary adjustments and increased physical activity.
When included in a thorough diabetes care plan, intermittent fasting can be a useful strategy if it is appropriate for you.