Can Diabetics Do Intermittent Fasting?

Intermittent fasting is one of the most popular weight loss diets of the decade.

In 2019, it was the most searched diet on Google.

However, intermittent fasting isn’t for everyone, like patients with diabetes, children, or pregnant woman.

So, can diabetics do intermittent fasting?

In addition, there are safety risks for those who are on diabetic medication.

Intermittent fasting is a way of dieting that focuses primarily on when you eat rather than what you eat.

It involves dividing your time into an eating period and a fasting period.

There are several ways to divide your time into these two categories with the most popular being 8 hours of eating followed by a 16-hour fasting period.

Is Intermittent Fasting Good For A Diabetic Person?

At a glance, the concern with intermittent fasting for diabetics is clear, as the long fasting periods involved which is contrary to the normal recommendations for diabetics.

Since intermittent fasting has been proven to be an effective way to improve insulin control, a lot of research has gone into finding a way for people with diabetes.

This research has paid off because it has been established that pre-diabetics or diabetics who are not on medication can go on an intermittent fasting diet with no problems.

People with diabetes can also go on an intermittent fast as long as they are under a physician’s and a nutritionist’s supervision.

In addition, intermittent fasting is an effective way of losing weight.

Like all weight loss diets, intermittent fasting puts you in a calorie deficit, and it does so by reducing the amount of time you can eat.

Most people find it sustainable in the long term because it does not exclude food groups like most diets.

Other than that it has also been shown to reduce inflammation and maintain optimum cholesterol levels.

A healthy weight, reduced inflammation, and optimal cholesterol levels are all beneficial to someone with diabetes.

During a fast, blood sugar is low.

The medication a person with diabetes takes may further lower the sugar level, dropping it to levels lower than is healthy, causing a condition known as hypoglycemia.

Hypoglycemia is simply low blood sugar.

For this reason, diabetics are supposed to avoid fasting as part of their lifestyle change.

Dehydration is also a cause for concern in fasting diabetics.

Restricting water when fasting dehydrates the body, and some diabetes medications like SGLT-2 inhibitors further dehydrate the body.

Therefore, even during fasting periods, people with diabetes who practice intermittent fasting should still have water and other low-calorie drinks like green tea to stay hydrated.

Despite these risks, people with diabetes can still safely fast and receive all the benefits as long as their diet is done under the supervision of a physician.

The physician can adjust the medication dosage and timing so that hypoglycemia does not result from the intermittent fasting diet.

For a long while, this made most healthcare professionals discourage the use of intermittent fasting. 

However, some research has shown that it can be safely done.

It is mandatory for anyone with diabetes and under medication to get their physician’s green light and guidance before and during their intermittent fasting. 

The main concern with fasting while on medication is that blood sugar is already low during fasting.

After a couple of hours without eating, your body runs out of sugar which is the first fuel option.

At this point, your body starts to burn fat as the main fuel source.

During this time, your blood sugar levels are at their lowest. Normal people are able to tolerate this with no harmful consequences.

However, people with diabetes on medication need to be extra careful because, during fasting periods, their medication may further lower their sugar, pushing them into hypoglycemia.

A 16-hour fast also can lead to hyperglycemia, which is high blood sugar.

Intermittent fasting can lead to hyperglycemia if, after the 16-hour fast, the person is so hungry that they eat loads of high-carbohydrate food.

This raises their blood sugar to unsafe levels.

As a rule, if you’re a diabetic on an intermittent fast, avoid overeating or eating too many carbs as the first meal after your fast.

While ways can be found to ensure a 16-hour fast is safe, longer periods of fasting like 24 hours or more are not recommended for diabetics as they come with a higher risk of hypoglycemia.

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This is first on the list because it is the safest method of fasting for diabetics.

The 16-hour period is not extreme as one is asleep for about half this time.

It is also easier to adjust medication because of the shorter fasting period.

The routine that comes with the 16:8 method also makes changing your medication to fit your lifestyle easier.

The 5:2 method involves a whole week instead of a day like the 16:8 method.

In the 5:2 intermittent fasting method, you eat normally for five days of the week and then eat only a portion, usually a quarter of your normal calories for 2 nonconsecutive days.

An example would be eating normally(about 2000 calories) on Mondays, Tuesdays, Thursdays, Fridays, and Sundays.

On the remaining days, that is, Wednesdays and Saturdays, you eat only 500 calories.

These two days are considered your fasting days.

This is the second best for diabetics because you only have to check your sugars more closely on only two days of the week.

However, the calories are so low on fasting days that there is an extra risk for hyperglycemia.

There there’s the eat-stop-eat method, which is relatively similar to the 5:2 method.

The only difference is that instead of eating 500 calories on the fast days, you go on a full-on fast where you can only have water and zero-calorie drinks like green tea.

This method is not recommended for people with diabetes because for two days a week, your sugars could fall so low that you develop hypoglycemia.

Since it is the longest fasting period of 24 consecutive hours, it has a higher risk of low blood sugar.

It is essentially a stricter version of the 5:2 method.

In addition, the “alternate day fasting” type of intermittent fasting involves eating whatever you want on eating days and eating nothing on fasting days.

Eating days and fasting days alternate and this method have some variations where you can eat up to 500 calories on fasting days.

It is quite easy to remember and keep a schedule on this method but it is one of the least recommended methods for diabetics to go on an intermittent fast.

With all methods of intermittent fasting, there is a risk of developing low blood sugar during the fast.

This remains a risk on an alternate day fasting because fasting last 24 hours.

In addition, high blood sugar is also a risk because you are allowed to eat what you like on the eating days.

This can raise your sugar levels to well above the normal range.

High blood sugar can be mitigated in this method by watching your carbohydrate intake even on eating days.

The warrior diet form of intermittent fasting gets its name from its alignment with the eating patterns of ancient warriors.

The eating pattern for the warrior diet is eating very small portions of food for 20 hours, usually during the day.

Most of the eating is done in a four-hour window during the night.

This diet is clearly more restrictive than the 16:8 period so it is not a good option for diabetics. 20 hours of fasting increases the chances of low blood sugar.

Therefore, the warrior diet is not recommended for diabetics.

In conclusion, the best way for a diabetic to participate in intermittent fasting is the 16:8 method.

Intermittent fasting also comes with several other benefits for the body that improves the health of people with diabetes.

For example, weight loss is the primary goal of intermittent fasting and with weight loss comes improved insulin sensitivity and general health.

Reduced inflammation is also a consequence of intermittent fasting which is also beneficial for diabetics.

Generally, the current information on the impact of intermittent fasting on diabetics is positive.

However, this is only applicable to people who take safety precautions to prevent high blood sugar and low blood sugar.

These precautions include working with a registered nutritionist or dietitian, informing your doctor and seeking their guidance, and regularly monitoring blood sugar to ensure they are in the safe zone.

Diabetics who do not follow these safety precautions can end up worsening their condition as a result of constant fluctuations in blood sugar levels.

For example, without the guidance of a nutritionist, a diabetic may eat too many carbohydrates and raise their blood sugar above normal levels.

On the other hand, they may experience low blood sugar during fasting without consulting their doctor on medication.

Because of such fluctuations, their attempt at intermittent fasting can be counterproductive and worsen their diabetic symptoms like shaking and frequent urination which is characteristic of low blood sugar and high blood sugar.

People with diabetes can safely intermittently fast but precautions must be taken to ensure safety.

You must inform your doctor before starting your intermittent fasting journey.

Your doctor will examine you and determine how to make it work.

Once you get approval, your doctor will help guide you and monitor you in terms of when and how much medication to take.

It is imperative that you don’t go overboard with your first meal to prevent hyperglycemia after your fast.

When you’re on intermittent fasting, monitor your blood sugar more regularly so that you notice any sugar highs and lows and act on them promptly.