Intermittent Fasting in the control of Type 2 Diabetes: A Literature Review

Introduction and Background:

The prevalence of type 2 diabetes is increasing around the world. Type 2 diabetes increases the risk of kidney failure, cardiovascular disease, and death. There are therapeutic options available for type 2 diabetes, like metformin and insulin injection, however alternate or adjunctive therapies are also of interest. With the rising popularity of intermittent fasting, it has been suggested as a potential non-medication therapy for people with type 2 diabetes. Intermittent fasting requires its followers to eat during restricted hours but allows them to eat any food. There are several forms of intermittent fasting, including alternate day fasting, time-restricted feeding, and fasting associated with Ramadan. However, there are uncertainties about the effectiveness and safety of intermittent fasting for people with type 2 diabetes. Therefore, the objective of this literature review is to summarize the literature on the effects of intermittent fasting on type 2 diabetes, the mechanism of action of intermittent fasting, and any potential adverse events associated with intermittent fasting.

Results: 

In most studies, intermittent fasting led to improvements in blood glucose concentrations. Studies also showed that intermittent fasting improved insulin sensitivity and glucose metabolism in the liver by regulating circadian rhythm and activating SIRT1 to suppress hepatic glucose production. Intermittent fasting increased the rate of glucose uptake and the expression of SIRT3 in skeletal muscle. This reduces inflammation and improves insulin sensitivity in the skeletal muscles to maintain blood glucose concentrations in the body. Lastly, no serious adverse events were observed in the examined studies reviewed.

Conclusion: 

The evidence shows the benefits of intermittent fasting in controlling blood glucose concentrations, and that liver and skeletal muscle play important roles in it. Although no serious adverse events were reported during fasting among examined studies, hypoglycemia is still a concern for people with type 2 diabetes. Further studies in intermittent fasting among a larger sample size of people with diabetes should be conducted. It is recommended that people consult their physician before undertaking any type of fasting.