Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin

Written By Claire C

By Suleiman Furmli, Rami Elmasry, Megan Ramos, and Jason Fung

The Bird’s Eye View:

  • A case study of 3 patients with insulin-dependent type 2 diabetes
  • Shows the effective use of therapeutic fasting to reverse the patients’ insulin resistance
  • Patients were instructed to follow a scheduled 24-hour fast 3 times a week for several months
    • Over this time period, they were evaluated to glycaemic control and other measures related to diabetes
  • There were five outcome measures used in the case study
    • Time to discontinuation of insulin
      • The most important takeaway from the study was that all three patients were able to completely discontinue their insulin use
      • Two of the patients discontinued all their diabetic medications and the third patient discontinued three out of four of their diabetic medications
      • Time to discontinuation of insulin ranged from 5 to 18 days
    • Fasting blood glucose levels
    • Serum A1C level (measures the percent of hemoglobin in your blood are coated with sugar, higher levels indicated poorer blood sugar control)
      • Reduction for all patients
    • Patient weight
      • All patients lost a specific amount of weight
      • This weight loss will likely reduce the risk of further complications from diabetes
    • Patient waist circumference
      • Decreased in all patients

Type II Diabetes Background Info:

  • Chronic disease that’s closely linked to the current obesity epidemic
  • Requires life-long medical attention due to its many microvascular, macrovascular, and neuropathic complications
    • Microvascular complications are those that affect small blood vessels
      • Retinopathy
      • Nephropathy
      • Neuropathy
    • Macrovascular complications are those that affect large blood vessels
      • Ischemic heart disease
      • Peripheral vascular disease
      • Cerebrovascular disease
  • These complications arise due to the combination of insulin action resistance, lack of insulin secretion, and excessive glucagon secretion

Problems with the current treatments for Type II Diabetes:

  • Insulin costs are rising, so therapeutic fasting as a treatment could save patients a significant amount of money
  • Reduced use of syringes and blood glucose monitoring can increase patient comfort 
  • Lifestyle modifications are understood to be important for Type II Diabetes but are often difficult in real-world application 
    • Other modifications have had little success in achieving adequate glycaemic control  
  • Alternatives include bariatric surgery, but it can be invasive, costly, and has many associated risks 
    • Plus, the long-term effects of the surgery are minimized by a lack of lifestyle modifications 
  • Medications can help manage diabetes symptoms, but don’t do much to prevent or reverse the progression of the disease

How fasting fills the gap in diabetes care:

  • Similar intensive caloric and hormonal benefits as bariatric surgery without having to go through intensive surgery
  • Can help reverse the progression of type II diabetes without the negative side effects and financial burden associated with many medications 

Other Fasting Flamingo resources related to Type II Diabetes:

  • James Cracknell is running 100 miles in five days, while fasting 
    • In September of 2020, James Cracknell and a group of seven other runners completed a 100 mile run over 5 days.  Plus, they consumed only water and did the entire run in a fasted state.  Their goal was to prove that our bodies can, and maybe should, run on little-to-no carbohydrates. 
  • The Obesity Code – Book Summary 
    • Struggling to lose weight? Or reverse obesity? If you want to understand why you gain weight and how to reverse it — this is the book for you. Don’t get what the big deal is about fasting and why reducing insulin is game-changing, this is for you.
    • Fung disproves the calories in calories out model of weight gain and thoughtfully explains how hormones (particularly insulin) m

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