D: What Do You Go Without When Fasting
MM: Its important to differentiate:
- A carbohydrate fast means not eating any carbohydrates. This approach can be used by athletes before a competition, or as part of glycemic adjustment .
- A complete fast means not eating any food. It is sometimes used in hospital protocols for illnesses related to the liver or pancreas.
What Is Intermittent Fasting And How Is It Done
Even if youve never tried IF, youve likely fasted before, without even thinking about it. Fasting is often required for blood tests, medical procedures, or surgery, for example.
When you are fasting, you naturally get fewer overall calories, says Vandana Sheth, CDCES, a dietitian and nutritionist who specializes in diabetes management in her own practice in Torrance, California. The fasting state also causes an increase in growth hormone levels, increase in norepinephrine, and decrease in insulin levels, and these changes in the hormones also cause an increase in our metabolic rate. All of these factors of intermittent fasting help with weight loss.
There are different ways to do IF, including skipping meals and eating only during a certain time period, or restricting calories on certain days of the week and eating normally on other days, according to the Association of Diabetes Care & Education Specialists. The most common IF diets consist of a 16-hour daily fast, a 24-hour fast on alternate days, or a two-day-a-week fast on nonconsecutive days, according to the authors of the Nutrients analysis.
Whatever plan you choose after consulting your care team, including a dietitian who specializes in diabetes should be tailored to your lifestyle, type 2 diabetes symptoms, and nutritional needs.
D: People Talk A Lot About Carbohydrate Fasting For People With Type 1 Diabetes Can You Tell Us More About That
MM: Carbohydrate fasting is usually done during a short hospital stay, in the diabetes ward. It must be done under medical supervision. The fast consists of eating carbohydrate-free foods with constant glycemic monitoring , after injecting your usual long-acting basal insulin, for a period of 24 hours.
A days meals might be:
- Breakfast: coffee, black tea or herbal tea, without milk
- Lunch: white fish, cheese
- Dinner: ham, salad
Throughout the day, water and/or hot drinks without milk are consumed.
Be careful not to eat too much protein or fat during the 24 hours they can make it difficult to interpret the test.
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When Things Go Awry
When we eat food, the pancreas goes to work, releasing enzymes that help to break down food and hormones that help the body handle the influx of glucose. One of these hormones is insulin, and it plays a key role in managing glucose levels in the blood.
And here is where things can go wrong. If the pancreas doesnt make enough insulin or stops making it altogether, in the case of type 1 diabetes glucose levels in the blood can rise too high.
In the short term, high blood glucose levels can make you feel downright bad. Thirst, frequent trips to the bathroom, fatigue and weight loss are all symptoms of high blood glucose . If not treated, more serious issues can occur, such as diabetic ketoacidosis. Chronic high blood glucose levels can lead to complications such as heart, kidney and eye disease, as well as nerve damage. So, its all about the blood glucose.
Before You Try Fasting
Talk to your doctor first. If you have type 1 diabetes, other health problems due to diabetes, or have had hypoglycemia, your doctor may recommend you not fast.
If your doctor says itâs OK to try, ask if you need to check your blood sugar more often or adjust your diabetes medication during and after fasting.
Watch for signs of low blood sugar. If you start to feel shaky, sweaty, or confused, your blood sugar may be too low. Stop fasting right away and do what you normally would to treat hypoglycemia. For example, eat a glucose gel or have a sugary drink followed by a small, balanced meal when your blood sugar level is back to normal.
Be careful about what you eat after fasting. Eating too many carbohydrates after fasting can cause your blood sugar levels to become too high. Choose healthy, balanced meals and snacks.
Use caution. Donât do tough workouts while youâre fasting. Hard exercise can make your blood sugar levels dip, which can lead to hypoglycemia. Ask your doctor what activities are OK to do, or just take a break.
Stay hydrated. Having diabetes puts you at risk of dehydration, which can make your blood sugar harder to manage. Drink lots of water and calorie-free beverages when you fast.
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The Risks Of Fasting With Diabetes
As well as not eating food , fasting is also usually a time of prayer, reflection and purification. If you treat your diabetes with certain medications such as insulin, there is also the danger of the blood sugar levels after fasting becoming too low. This can lead to a hypo, or having your blood sugar levels too high which can lead to diabetic ketoacidosis , which would require hospital treatment. The symptoms of DKA include feeling very thirsty and passing a lot of urine.
If someone is fasting and does not take in fluids to reduce their thirst, this will accelerate dehydration and they will require urgent admission to hospital.
If you’re worried about fasting with diabetes, check with your GP or diabetes team, particularly if you’re not sure what to do with your diabetes treatment during fasting. If you can’t get hold of them, it’s best not to fast. And if you require urgent medical help you can use the NHS 111 online service.
Effects Of Prolonged Fasting On Metabolic And Hormonal Markers During Ogtt
OGTTs were discontinued due to hypoglycemia three times in three people in each trial arm. The median of the 120 min OGTT plasma glucose AUC were similar in comparison of both fasting regimes . Mean 120 min plasma glucose levels were also similar in comparison of both trial arms and three episodes of hypoglycemia occurred after the prolonged fasting during the OGTT – those three people had also an episode during the overnight fasting period .
Figure 2 Comparison of 12 hrs fasting vs. 36 hrs fasting for plasma glucose , insulin , cortisol , glucagon and beta-hydroxybutyrate . * indicates significant difference for the specific time point n comparison of both trial arms .
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Staying Well While Fasting
If you decide to fast, it is important to test your blood glucose levels more often as your blood sugar levels after fasting eight hours may drop too low . This is more likely to happen if you are unwell, treat your diabetes with insulin or some diabetes medications, or both. Speak to your diabetes team about this.
If you experience the symptoms of a hypo, such as feeling shaky, sweaty and disorientated, you must break the fast immediately and treat it with your usual hypo treatment, like glucose tablets, a sugary drink or GlucoGel, followed by a snack such as a sandwich or a bowl of cereal.
If you have to break your fast for any reason, continue your meals as normal for that day. You may be able to make up the fast at a later date or provide meals to the needy.
If you have type 1 diabetes, there is also a danger that your blood glucose levels may run too high and result in a build-up of ‘ketones’. This could potentially result in a serious condition known as ketoacidosis. The symptoms of high blood glucose levels might include feeling very thirsty, passing a lot of urine or extreme tiredness. If your blood glucose levels stay high and you experience these symptoms, speak to your healthcare team.
What Is Blood Glucose Anyway
Blood glucose, or sugar, is sugar that is in your blood . It comes from the food that you eat foods that contain carbohydrate, such as bread, pasta and fruit are the main contributors to blood glucose. The cells in our bodies need glucose for energy and we all need energy to move, think, learn and breathe. The brain, which is the command center, uses about half of all the energy from glucose in the body.
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Potential Drawback Of Intermittent Fasting: It May Harm Blood Sugar Control
On the other hand, some experts say that IF carries risks, especially for people who need to keep their blood sugar levels stable. For starters, skipping whole meals can result in poorer blood glucose control, not to mention issues such as fatigue and reduced energyand, thus, an increased risk of injury.
Skipping meals may also cause people to make poor diet choices, which can have the opposite effect on their waistline and blood sugar. If you havent eaten for hours, you may be more inclined to reach for a carb-heavy pastry or plate of pasta, for instance.
Blood sugar management can be a real concern with intermittent fasting for people with type 2 diabetes, Sheth says. Thats why its important to discuss intermittent fasting with your physician, monitor your blood sugar closely, and know that your medications may need to be adjusted as well. Your dietitian and diabetes care and education specialist can help guide and support you through this process.
A plan that severely restricts a persons calories or asks them to skip meals can be hard to stick with long term, too, says Ruth S. Pupo, CDCES, who practices at Adventist Health White Memorial in Los Angeles. While losing weight can be beneficial for people with diabetes, because it increases insulin sensitivity, putting weight back on can have the opposite effect, increasing the risk for diabetes complications.
What Is The Fasting Blood Sugar Test Used For
The fasting blood sugar test is also used to test the effectiveness of different medication or dietary changes on people already diagnosed as diabetic
Fasting blood sugar levels are measured by taking a blood test after a period of fasting, usually of 8 hours without food. Typically, fasting blood glucose levels are taken in the morning before any breakfast is eaten. When having your fasting blood glucose levels take, you should not have any drinks apart from water during the period of fasting.
A fasting blood glucose test can be useful to see how well the body is able to manage blood sugar levels in the absence of food. When we do not eat for several hours, the body will release glucose into the blood via the liver and, following this, the bodys insulin should help to stabilise blood glucose levels.
A fasting blood glucose test therefore shows:
- Whether the body is able to bring down the raise in blood glucose levels from the previous meal
- How effectively the body copes with its own release of glucose
The target for fasting blood glucose levels are the same as the targets for before meal readings.
- For adults with diabetes, the target level is between 4 and 7 mmol/l
- For children with diabetes, the target level is between 4 and 8 mmol/l
However, some people may be set individual targets, by their doctor, that differ to the above levels.
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D: What Is The Best Approach To Fasting
MM: To ensure that your fast is effective, there are several steps that should be carefully followed.
1 Make a doctors appointment for a full physical exam, and get your diabetologists permission before deciding to fast.
2 Prepare yourself mentally, and set a goal and a length of time.
3 Prepare your body by gradually reducing your dietary intake beforehand.
Its important to check in with your doctor regularly throughout the fast, and to stay hydrated.
Tips & Tricks For A Healthy Fasting Experience
Dr. Ratner said, The health benefits of IF and TRF are due to calorie reduction. If people overcompensate when they are eating, the impact is lost. If you decide you want to pursue some sort of intermittent fasting plan, heres what you should keep in mind:
Intermittent fasting and time-restricted feeding are two ways people reduce calorie consumption over time as an alternative to traditional dieting. While research on these forms of fasting is limited in populations with diabetes, some evidence suggests that IF and TRF may offer people with diabetes or prediabetes a means to lose weight, stabilize blood sugar levels, and increase sensitivity to insulin.
While IF and TRF appear safe for people with diabetes, fasting can increase the risk of hypoglycemic events, especially in individuals taking medicine to lower blood sugar levels. Everyone’s body is different, so before trying IF or TRF, consult your healthcare professional to help determine if this plan would be safe and helpful for your health and wellbeing.
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Can You Fast If You Have Diabetes
Yes in some circumstances, but it depends on how healthy you are.
Ultimately, it is a personal choice whether or not to fast. However, if you do choose to fast, then you must consult your doctor or healthcare team, to make sure that you are able to look after yourself properly. We’ve got lots more information about fasting and how to do it safely.
What Are The Health Benefits Of If
Overeating, which is a common issue in the United States today, can contribute to a variety of health issues, including insulin resistance and overweight and obesity. Researchers note that, Because animals, including humans, evolved in environments where food was relatively scarce, they developed numerous adaptations that enabled them to function at a high level, both physically and cognitively, when in a food-deprived/fasted state.
A considerable volume of research has demonstrated that intermittent fasting appears to lead to a variety of health benefits, in particular on various metabolic parameters. Some potential benefits in people that are highlighted in scientific literature include:
- Weight loss and maintenance
- Improved cardiovascular parameters, including serum cholesterol and triglyceride reduction
In addition, animal studies indicate that IF may positively modulate various disease processes, including:
- Type 2 diabetes
- Various neurological disorders
- Cancer
Excitingly, recent small-scale human clinician trials of IF in patients with multiple sclerosis and cancer have yielded very promising results. However, more well-controlled clinical studies in human subjects are needed to further elucidate the relevance of these findings and the abundant data from animal model studies when it comes to the modulation of these specific health disorders.
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Struggles With Calorie Restriction
Some people with diabetes could minimize their need for diabetes medication by continually restricting their calorie intake, which scientists know reduces body weight and improves metabolic health.
However, the authors of the review note that people can struggle to sustain daily calorie restriction for extended periods.
Some people may find it easier to practice intermittent fasting, which shows promise as a way to improve metabolic risk factors, reduce body fat, and promote weight loss in obesity.
To assess the evidence, the authors searched databases for review articles, clinical trials, and case series related to type 2 diabetes and intermittent fasting published between 1990 and 2020.
They concluded that this type of diet may improve several key features of the disease. The improvements include:
- reduced body weight
- lower levels of leptin
- increased levels of adiponectin
Some studies found that patients were able to reverse their need for insulin therapy during therapeutic intermittent fasting protocols with supervision by their physician, they write.
For example, a case study followed three people with type 2 diabetes for several months after they started an intermittent fasting diet, which involved three 24-hour fasts per week.
Over the course of the study, all participants had significantly reduced levels of HbA1c, which is a measure of the average amount of glucose in the blood.
How To Fast Successfully When You Have Type 1 Diabetes
To write this article, we consulted a dietitian. If you have Type 1 diabetes, the decision to fast is a serious one, and should only be taken after consulting with your healthcare provider. Doctors and dietitians, as health care professionals, are best placed to evaluate the possible risks fasting may pose for your diabetes.
Springtime is a season that abounds with all kinds of fasting techniques. Our team interviewed Magalie Montel, a dietitian. She explained the right approach to fasting for those of us with Type 1 diabetes.
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Is Intermittent Fasting Safe For People With Prediabetes And Type 2 Diabetes
While studies on intermittent fasting have demonstrated positive improvements in several key measurements of diabetes , it is important to know that fasting might have negative side effects for someone with diabetes. In a clinical study on intermittent fasting among 137 people with type 2 diabetes, dizziness, headaches, hunger, and hypoglycemia were the side effects most often reported. This study was conducted using the 5:2 IF approach.
When it comes to blood sugar, Both IF and TRF will drop a persons glucose levels, meaning that medication adjustments are necessary to avoid hypoglycemia during the period of calorie restriction, said Dr. Robert Ratner, a long-time scientific and medical leader in diabetes. Changes in eating patterns on a daily basis will also require medication adjustments to keep glucose levels in range.
There is currently no evidence to suggest that TRF would be less safe than IF, in particular because the fasting windows for TRF are shorter. IF and TRF appear to be most safe for people who do not take glucose-lowering medications that could cause hypoglycemia.