Intermittent fasting may help patients with type 2 diabetes – study

Intermittent fasting may help people with early type 2 diabetes improve their blood sugar levels, lose weight, and lower their blood pressure, according to a new study.

For the trial, roughly 400 participants in China either took the antidiabetic medications metformin or empagliflozin or followed a 5:2 intermittent fasting plan, in which people fasted for two nonconsecutive days of the week and spent the other five eating a normal breakfast and lunch and having a meal replacement for dinner.

By the end of the 16-week study, participants who adopted the 5:2 diet saw a blood sugar level reduction of 1.9 per cent, compared with 0.3 per cent and 0.4 per cent among those who took the drugs.

In addition, 80 per cent of the 5:2 dieters had blood sugar levels that put them in diabetes remission, meaning their levels returned to a non-diabetes range without the need for medication, according to an international expert group’s standards.

The findings, published in the journal JAMA Network Open, suggest that lifestyle interventions may be more effective than drugs for overweight people with recently diagnosed type 2 diabetes, according to the researchers from nine Chinese medical centres.

“I’m convinced that fasting protocols and losing weight with lifestyle changes is very important and should always be the baseline,” Dr Alexandra Kautzky-Willer, head of the division of endocrinology and metabolism at the Medical University of Vienna, told Euronews Health. She reviewed the findings but was not involved with the study.

Across the globe, about 1 in 10 adults – 537 million people – has diabetes, according to the International Diabetes Federation.

Type 2 diabetes is associated with obesity and low physical activity, and while drugs like insulin and weight-loss medications can help patients manage the condition, research shows that dietary and other lifestyle changes are key to reducing health risks.

“At the moment, we have so many new drugs,” Kautzky-Willer said, such as the weight-loss and diabetes medications Ozempic and Wegovy.

“It’s good to have both the diet and, if necessary, drugs in the long run, because type 2 diabetes is a lifelong chronic disease”.

Notably, the trial was funded by Beijing MetabolicControl Technology Co Ltd., which makes the low-calorie meal replacement used in the study, though researchers said it had no impact on the results.

They also said more research is needed to learn whether it was weight loss or the 5:2 fasting approach itself that improved blood sugar levels, and what the long-term outcomes are of lifestyle interventions for diabetes management.

Research from the United Kingdom, for example, found that while many type 2 diabetes patients initially lost weight and achieved remission, only 13 per cent were still in remission after five years.

Even so, over a 12-year period, diabetes remission is associated with lower risk of heart and kidney complications compared with patients who were never in remission. 

Because it can be difficult to keep weight gain and type 2 diabetes at bay, a plan that involves only two days of intermittent fasting may be easier for patients to maintain than a more extreme diet change, Kautzky-Willer said.