Tuesday 16 July 2019

Ask the doctor: Will intermittent fasting reverse my type 2 diabetes?

Rather than fasting, try to develop a healthy lifestyle
Rather than fasting, try to develop a healthy lifestyle

Nina Byrnes

Question: I've read recently in the papers about a study that showed fasting can reverse type 2 diabetes. I am a woman in my 50s, have been living with type 2 diabetes for about five years, and am taking metformin. I struggle with food - I find it very hard to live a healthy lifestyle day to day, but I think I might be able to fast every second day, as the study outlined. My GP is tired of hearing me promising to lose weight and not following through so I would like to see what you say before I approach it with him. What do you think?

Answer: Pre-diabetes means that your fasting blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes. Once the sugars reach a sustained high level, you have moved to type 2 diabetes. Risks for type 2 diabetes include being over 45, being overweight or obese, inactivity, a family history of type 2 diabetes, being of African or Asian descent, working shift work, having polycystic ovarian syndrome (PCOS), having diabetes during pregnancy or having a baby larger then 9lbs (4kg).

The most important thing to do when you have diabetes is to lead a healthy lifestyle. The first step needs to be keeping your sugars under control. Medication prescribed for diabetes will help with this, but eating less and burning more energy are also key to blood-glucose control.

Intermittent fasting has gained a lot of popularity. It is based on the theory that on days you fast you "burn more". Your body uses up its glucose reserves and has to start burning fat. There are some studies that show this helps reduce insulin resistance, and can be effective for weight loss. Significant weight loss and reduced insulin resistance may help reverse type 2 diabetes.

The most popular fast is the 5:2 fast. You eat normal amounts five days a week and pick two days (not consecutive) where you fast, eating only approximately 500kcal those days. The important point to make however is you must eat normally the other days. If you are a consistent overeater then any calories lost will just be made up on other days. If you find it hard to eat well in general, I think you would be much better off putting your energy into developing a healthy lifestyle and diet seven days a week. This is sustainable and will help you more over the long-term. There is also a risk of developing hypoglycaemic episodes if you fast while taking diabetic medication.

If you are overweight, aim to lose 5pc to 10pc of your body weight. Even if you are still overweight at this point it will have benefits for your health. Move more. Being active for at least 30 minutes on most days will help reduce your risk of complications of type 2 diabetes.

Eating a healthy diet is essential for weight loss and well-being. Cut out excess sugar. Avoid sugary drinks, don't add it to tea or coffee and be aware of the sugar content of the foods you eat. Avoid saturated fats. Include healthy fats in small amounts. Your diet should include lots of fresh vegetables and carbohydrates should be whole grain.

It is important to be aware of your overall intake of carbohydrates. Remember even brown bread or pasta will break down to sugar in the body. Portion control is extremely important, whatever the food. Eat fruit in moderation, one to three portions a day.

A healthy lifestyle will not only reduce your risk of uncontrolled diabetes, it will make you feel better overall. Leading a healthy lifestyle isn't just putting years in your life - but really life in your years.

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