Therapeutic intermittent fasting might assist remove the necessity for insulin and different glucose-lowering medicines in sufferers with kind 2 diabetes, a brand new case sequence suggests.
Findings from three cases had been revealed on-line October 9 in BMJ Case Reports by Suleiman Furmli, MD, of the Department of Family Medicine on the University of Toronto, Ontario, Canada, and colleagues.
The three sufferers had all been referred to an intensive dietary administration clinic and had been taking not less than 70 items/day of insulin. After a number of months of intermittent fasting — both on alternate days or thrice weekly — all three had been in a position to discontinue insulin whereas enhancing their glycemic management. They additionally misplaced substantial quantities of physique weight and had diminished waist circumferences.
“Medically supervised, therapeutic fasting regimens can help reverse type 2 diabetes and minimize the use of pharmacological and possibly surgical interventions in patients with type 2 diabetes,” Furmli and colleagues write.
The sufferers got 6 hours of training on diabetes and nutrition and particular directions for fasting. They ate solely dinner and consumed limitless very low-calorie fluids on fasting days, and ate each lunch and dinner on nonfasting days. Low-carbohydrate meals had been beneficial when eating meals. They adopted up with the treating doctor each 2 weeks.
Success Times Three
Patient 1 was a 40-year-old man with kind 2 diabetes for 20 years who additionally had hypertension and hypercholesterolemia. At baseline he was taking metformin, canagliflozin, and long- and short-acting insulin. After fasting thrice every week for 7 months, he was in a position to discontinue all of the medication aside from canagliflozin, his HbA1c dropped from 12% to 7.5%, his weight was diminished from 84 kg to 74 kg (184 lb to 163 lb), and his weight circumference decreased from 100 cm to 87 cm (43 in to 34 in).
He reported having no issue with fasting and that he felt “excellent” on fasting days.
Patient 2 was a 52-year-old man with kind 2 diabetes for 25 years in addition to continual kidney illness, prior renal cell carcinoma, hypertension, and hypercholesterolemia. He had been taking a fixed-dose insulin combine.
After following the identical routine as affected person 1 for 11 months, affected person 2 got here off the insulin. His HbA1c dropped from 7.2% to 6.0%, his weight was diminished from 61 kg to 50 kg, and his waist circumference fell from 123 cm to 110 cm. He reported feeling “terrific.”
Patient 3, a 67-year-old man with kind 2 diabetes for 10 years who additionally had hypertension and hypercholesterolemia, was taking metformin and pre-mixed insulin. After alternating fasting days for 11 months, he eradicated each diabetes medicines, his HbA1c dropped from 6.8% to 6.2%, his weight dropped from 97 kg to 88 kg, and his waist circumference decreased from 123 cm to 110 cm.
He stated he discovered the fasting “easy,” that his carbohydrate cravings had disappeared, and that his power ranges had been increased.
“Therapeutic fasting is an underutilized dietary intervention that can provide superior blood glucose reduction compared with standard pharmacological agents,” the authors conclude.
The authors have reported no related monetary relationships.
BMJ Case Reports. Published on-line October 9, 2018. Full text