Is Intermittent Fasting A Safe Choice For Diabetics To Lose Weight And Control Blood Sugar Levels
In the recent past, intermittent fasting has become popular, mostly for losing weight. But some global studies have shown that it can lead to diabetes remission, perhaps due to weight loss. Just a week ago, a study published in the Journal of Clinical Endocrinology and Metabolism showed how over 44 per cent of people on an intermittent fasting diet for three months achieved Type-2 diabetes remission, discontinued their medication or insulin and maintained it as such for the follow-up period of one year. “While this is calorie-restricted eating and comes in a variety of formats, no particular one has proven best for people with diabetes,” says Dr Anil Bhoraskar, Secretary, Diabetic Association of India and Senior Diabetologist at SL Raheja Hospital, Mumbai.
Is intermittent fasting safe for people with diabetes?
Can intermittent fasting cause diabetes?
There is no direct evidence to suggest that it does. A 2020 study on rats found that fasting every other day for 12 weeks led to an increase in abdominal fat, damage to pancreas cells and the development of insulin resistance.
While intermittent fasting diets come in a variety of formats, no particular one has proven best for people with diabetes.
16:8: People eat all meals within an eight-hour window followed by 16 hours of fasting. Many people fast from 8 pm until noon the next day and keep their eating window between noon and 8 pm
Can intermittent fasting reverse diabetes in some patients?
Losing Weight And Insulin Resistance
Insulin is the hormone that regulates blood sugar levels in the body and helps your cells convert blood sugar into energy. In some people with diabetes, however, blood sugar levels are high for a sustained period of time, causing the pancreas to produce more and more insulin. Eventually, the cells stop responding to that insulinbecoming insulin resistant. Losing weight with insulin resistance is more difficult because your body converts blood sugar into fat instead of energy.
The solution? For a start, reducing the sugar and processed carbohydrates in your diet while increasing healthy fats along with vegetables and whole grains. Even a small improvement can make a big difference. Studies show that a weight loss of just 57 percent is enough to reduce the risk of diabetes by 58 percent in a person who has a high risk of the condition.
How Can I Treat High Blood Sugar
Talk to your doctor about how to keep your blood sugar levels within your target range. Your doctor may suggest the following:
- Be more active. Regular exercise can help keep your blood sugar levels on track. Important: dont exercise if ketones are present in your urine. This can make your blood sugar go even higher.
- Take medicine as instructed. If your blood sugar is often high, your doctor may change how much medicine you take or when you take it.
- Follow your diabetes meal plan. Ask your doctor or dietitian for help if youre having trouble sticking to it.
- Check your blood sugar as directed by your doctor. Check more often if youre sick or if youre concerned about high or low blood sugar.
- Talk to your doctor about adjusting how much insulin you take and what types of insulin to use.
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What Are Blood Sugar Targets
A blood sugar target is the range you try to reach as much as possible. These are typical targets:
- Before a meal: 80 to 130 mg/dL.
- Two hours after the start of a meal: Less than 180 mg/dL.
Your blood sugar targets may be different depending on your age, any additional health problems you have, and other factors. Be sure to talk to your health care team about which targets are best for you.
Making The Most Of Weight Loss Benefits
In general, Rinker recommends choosing lifestyle changes you can sustain rather than relying on fad diets for weight loss and weight management.
For example, the ADA suggests starting with the pillars of healthy eating: adding more fruits and vegetables to your diet, as well as lean meats and plant-based protein, and limiting processed foods and added sugar. Before you know it, youll be a pro at managing your weight as well as type 2 diabetes and its complications.
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What Glucose Levels Can Reveal About Your Metabolism
Excess body fat accumulates in our adipose tissue when we donât use the fuel weâve eaten, so the body stores it for later use. If later becomes never, thatâs when weight gain and other health-related problems arise.
What signals our bodies to store the food we eat as fat? Insulin is often assigned as the culprit.
In reality, insulin is a hormone secreted by the pancreas to manage the amount of glucose in your bloodstream. A 154-pound person has roughly 4 grams of glucose circulating in the blood< sup> 3< /sup> , an amount critical to maintain normal cell function. Insulin helps regulate this amount of glucose after you eat and when you exercise .
Insulin stops the flow of energy stored in your liver, muscles, and fat tissue until you use the energy thatâs circulating in your blood from your last meal.
When youâre metabolically healthyâarenât insulin resistant and donât have prediabetes or diabetesâyour pancreas releases just the right amount of insulin to maintain glucose homeostasis.
If you eat a lot of carbs or high-glycemic carbs, your glucose will rise and so will your insulin< sup> 4< /sup> . If you consume a carb-fat combo , your glucose response may be smaller initially, but glucose and insulin levels can become elevated< sup> 5< /sup> after a couple of hours.
Protein also stimulates insulin secretion, and combining carbs with protein or carbs with fiber and a little fat can reduce your glycemic response< sup> 6< /sup> .
Calories In/calories Out Is A Flawed Model
The process of gaining weight isnt as simple as one might think. The model of calories in/calories out that many of us are familiar with is flawed and doesnt consider the complex hormonal and biochemical pathways involved in energy balance, weight gain, and weight loss in the body.
The flaws of the calorie deficit model of weight loss can be pictured by imagining the human body as a car: The engine is our cells, the fuel tank is our fat stores, and the fuel within the tank is provided by the food we eat. As we drive the car along, the engine burns fuel to keep the car moving. By consuming food, we refill the tank as we go, preventing it from running dry. In this analogy, if we want to deplete our fuel tank , we can put less fuel in the tank or drive the car faster .
Different types of foods eaten at different times of the day and in different combinations can lead to unique hormonal responses in the body.
The original thought experiment now seems a lot more complex. What happens if we drive this more realistic car, except this time debris has clogged the air filter, preventing oxygen from entering and making conditions impossible for the fuel to burn efficiently? What if the engine oil is depleted and there is excessive friction and wear on the engine parts? This is a more accurate representation of the human body and the hormonal mechanisms of weight and energy balance.
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Women & Midlife Weight Gain
As women enter menopause around age 50, maintaining a consistent weight may suddenly become an uphill battle. Even if you keep up with the same exercise and eating habits, itâs not uncommon to start gaining.
So whatâs going on? During the transition from perimenopause to menopause, your bodyâs hormones go through a series of changes that cause your metabolism to slow, thanks to a declining estrogen level that drags down muscle mass with it. As a result, your body needs to burn fewer calories to keep you alive and activeâand more of that excess glucose is going to get stored as fat. So while your doctor may simply say, âeat less,â as the answer to your midlife weight gain, the real trick is eating smarter. When you focus on foods that keep blood sugar levels lower and more stable, you decrease your insulin spikes and risk of developing insulin resistance.
This makes monitoring blood sugar levels incredibly smart for women at midlife. As your bodyâs response to food changes, you can track whatâs going on by monitoring your glucose levels at every meal. Modifying your diet to align with your new reality is easier when youâre able to pick foods that actually work well with your bodyâs need to burn fat, instead of working against it.
What Are Clinical Trials And Are They Right For You
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
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What Role Does Insulin Play In Weight Loss
Insulin is the captain controlling our metabolism. Itâs what we call an âanabolicâ hormone, meaning it contributes to our bodiesâ growth. You may recall disgraced athletes caught using âanabolicâ steroids to âgrowâ muscle. Eating prompts the pancreas to release insulin into our bloodstreams. Once released, insulin starts barking orders. It tells our bodies to burn glucose . It shifts our metabolism away from burning fat and toward storing fat.
For a person with a healthy metabolism, say someone eating nutritious foods a few times a day, these insulin releases work perfectly. Their body metabolizes blood sugar and stores just enough fat. But like weâve said, many people suffer abnormal metabolism. We donât live in the hunter-gatherer environment of our ancestors. We live in a world with 24-hour fast food on every corner and store shelves lined with processed sugars designed to remain edible even after a nuclear apocalypse.
When we snack and eat these hyper-palatable processed foods , our bodies release too much insulin too often. Our metabolic captain starts barking more orders. Itâs voice gets louder. And what does a team do when the captain starts yelling and cussing? They stop paying attention. Too much snacking and low-quality food increases our bodiesâ resistance to insulin. The next time insulin asks our bodies to burn blood sugar, our metabolism doesnât listen. This makes weight loss very difficult.
Weight Loss Is More Complex Than Calories
The âcalories in, calories outâ method attempted to show people that weight loss can be simplified to a mathematical formula. Touted for years, this principle that you will lose weight by existing in a caloric deficit isnât as precise as it seems.
Consider: How can you know precisely how many calories you actually ingest and use every dayâ¦ and even if you devise a way to wade through the minutiae to find the answer, the daily response is a moving target.
While smartwatches and devices are getting better at approximating calories burned from movement and simply surviving, these numbers are estimates. Same for the number of calories you burn during rest. Although smart, these devices arenât intuitive enough to adjust for the possibility that eating in a caloric deficit can reduce your basal metabolic rate < sup> 1< /sup> .
You can log every morsel and sip you take every day in an app but the daily total number of calories you consume can be impacted by human error , not considering the thermic effect of food , and not accounting for the ways in which our gut microbiomes may determine< sup> 2< /sup> how well a calorie-restricted diet could work for each of us.
Food logging and activity tracking serve other important purposes, such as accountability and a trove of compiled data that can help show trends over time, but these methods only paint broad strokes on the total weight loss picture.
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Closing Thoughts: Why Should We Even Care About Losing Weight Spoiler Its Not Just About Looks
Being overweight is a risk factor for many problems: cardiovascular disease, cancer, diabetes, and premature mortality. It can also exacerbate hypertension, arthritis, gallstones, high cholesterol, low back pain, bronchitis, and musculoskeletal problems.
Excess fat also acts as a source of many signaling molecules in the body and is even thought to be an endocrine organ in its own right. Fat can secrete hormones and pro-inflammatory chemicals called adipocytokines, which are associated with insulin resistance. Visceral fat the type that surrounds organs and is most dangerous in terms of risk for chronic disease is also known to harbor many immune cells called macrophages, leading to further production of pro-inflammatory chemicals.
Given the relationship between glucose, insulin, and excess fat, real-time monitoring can provide a valuable tool to help individuals feel more empowered in their weight loss journey. Personal data helps individuals know specifically how their diet affects them and can inspire behaviors that promote optimal weight and long-term health and wellness.
Foods Play An Integral Role But Which Ones
Different diets tell you to eat different foods. Further, diets often say the foods promoted by other diets are bad for you. Remember, these âdietsâ are often tied to expensive cookbooks and membership programs food confusion isnât a bug in the system, itâs a feature.
To cut through the confusion, scientists created a tool called the glycemic index. The glycemic index assigns foods a value from 0-100, depending on how quickly they increase glucose. The lower the value, the better. An apple, for example, has a glycemic index score of 36. White bread, on the other hand, scores 75. Watermelon is 76. As far as blood sugar goes, apples are better for you than white bread and watermelon. I know, I know, I can hear you from here: âwell, duh.â
But the devil is in the details. As weâve learned time and time again, every body is different. The beautiful, sometimes frustrating part of good science is how it constantly improves. As we gather more data, weâve come to realize the glycemic index isnât a universal score. One person can metabolize a PB& J on white bread with barely a blip, but that same meal can send the next person into a Mt. Everest-sized glucose spike. More data, therefore, is better data and the more personalized the data, the more useful it becomes.
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Weight Loss And Glucose Control
Should the focus of nutrition therapy for type 2 diabetes be on weight loss or improved blood glucose control? shows that achievable weight loss has a modest effect on A1C levels. However, in several studies, weight loss was not associated with improvement in glycemia., Furthermore, other nutrition therapy interventions that tend to focus more on metabolic control and less on weight loss have been shown to improve A1C levels by 12%.
It is likely that early in the course of the disease process, when insulin resistance is still prominent, either energy restriction or weight loss will improve blood glucose levels. But as the disease progresses and insulin deficiency becomes more prominent, it may be too late for weight loss to be helpful. In fact, at later stages of the disease, when medications, including insulin, need to be combined with nutrition therapy, prevention of weight gain often becomes the goal. However, glycemic control should take precedence over concerns about weight.
Target Blood Glucose Levels After Meals By Age
Your target blood sugar level after eating will depend on how old you are, whether or not you have diabetes and how you are treating it , and whether you’re pregnant.
Here are some general guidelines for post-meal blood glucose levels:
- Children with diabetes: < 200mg/dl one hour after eating < 180 mg/dL two hours after eating
- Adults without diabetes who are not pregnant: 90-140 mg/dL two hours after eating
- Adults with diabetes who are not pregnant:< 180 mg/dL two hours after eating
- Adults with diabetes taking mealtime insulin: < 180 mg/dL two hours after eating
- Adults with diabetes not taking mealtime insulin:< 140 mg/dL two hours after eating
- Adults with gestational diabetes:< 140 mg/dL one hour after eating < 120 mg/dL two hours after eating
- Pregnant adults with preexisting type 1 or type 2 diabetes:< 110-140 mg/dL one hour after eating < 100-120 mg/dL two hours after eating
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How Does Food Affect My Blood Sugar
When you eat, your body breaks food down into carbohydrates, proteins, fats, vitamins, and minerals.
You need all of these parts for a healthy diet, but carbohydrates are really important when it comes to your blood glucose level. However, not all carbs change into blood sugar at the same rate.
Examples of foods that fit into each carb category include:
- Starches, or complex carbohydrates: Starchy vegetables, dried beans, and grains
- Sugars: Fruits, baked goods, beverages, and processed food items like cereals
- Fiber: Whole wheat products, chickpeas, lentils, berries, pears, and Brussels sprouts
The glycemic index is a carb ranking system that uses a scale ranging from zero to 100. You can use the GI to find out how different foods affect your blood sugar levels.
High GI foods are quickly processed and can cause a rapid spike in blood sugar levels. Low index foods are more slowly processed which leads to smaller blood glucose level changes.
Insulin And Glucagon: How To Manipulate Them And Lose Fat
Do you know what insulin and glucagon do in your body? If you have goals that include reducing your body fat, you really should learn about these hormones and how they affect fat storage.
Written by Tom KelsoLast updated on February 17, 2013
I know many of you lean, mean, workout machine Breaking Muscle readers could care less about body fat reduction. Youre already there. Your focus goes to your lift resistance amounts, improving training times, shoring up your exercise techniques, strategic planning to defeat your opponents, future competition preparation, and feeling good about your training. Thats how it should be.
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