Intermittent Fasting and DiabetesWritten by Expert DCES
April 1, 2022
Contributor: Barbara Eichorst, MS, RD, DCES
In partnership with
People fast for many reasons, including spiritual beliefs, weight loss, or managing daily glucose levels.
Intermittent fasting is used by many people with diabetes (PWD). Intermittent fasting includes periods of time when there is abstinence from calorie-containing food and drinks. There are several types of intermittent fasting, such as:
- Alternate day fasting, where there is no food consumed during alternate days
- Modified fasting regimens, where a specific percentage of calories are consumed on scheduled fasting days
- Time-restricted feeding, where calories are consumed within specific periods of times
Evidence indicates that fasting can aid in glucose management by reducing insulin resistance(1-3). Consequently, fasting can be one of the ways to manage your diabetes. However, there are some risks associated with it. If you choose to fast, four major risks to be aware of include:
- Diabetic ketoacidosis (DKA)
You can work with your diabetes care and education specialist (DCES) to develop a fasting management plan that includes how to identify, prevent, and treat risks associated with it.
- Whichever fasting method you decide to practice, you must adjust your medications and manage any risks.
- Choose healthy foods when you break the fast and during your eating time.
- Practice the 15:15 rule for hypoglycemia management to prevent consuming too many calories and getting hyperglycemia.
- Have an effective physical activity plan that is timed to support your fasting.
- Monitor your blood glucose before, during, and after you fast.
- Have a problem-solving strategy for hypo and hyperglycemia, which can happen during fasting and eating times.
- Develop coping strategies when fasting. Too oten, productive fasting times are associated with binge eating and can lead to disordered eating.
- Always break the fast when hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA), dehydration, or acute illness occur.
Safe fasting can be part of healthy diabetes management. However, safety comes first! Work with your DCES to develop an individualized fasting management plan. This way, you will achieve your goals with minimal risks.
- Arnason TG, Bown MW, Mansell KD. Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study. World J Diabetes 2017;15;8(4):154-164.
- Barnosky AR, Hoddy KK, Unterman TG, Varady KA. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl Res 2014; 164(4):302-11.
- Heilbronn LK, Civitarese AE, Bogacka I, et al. Glucose tolerance and skeletal muscle gene expression in response to alternate day fasting. Obes Re. 2005;13:574–81.
Barbara Eichorst, MS, RD, DCES, is the Associate Vice President of Clinical Practice and Research at Kindred at Home. Prior to Kindred at Home, Barbara has worked with Voluntis as a Diabetes Clinical Liaison, and with Healthy Interactions as Vice President of Clinical Care on a global program that involved over 120 countries. With the Conversation Map program, she has traveled to over 40 countries within the last eleven years. Barbara’s experience also includes work in Chicago as an insulin education specialist and a medical liaison. Barbara’s professional experience includes work at the Association of Diabetes Care and Education Specialists as a program director. Also, at the Chicago-based Rush University Medical Center, Barbara was a diabetes program manager. She has provided patient education in diabetes, weight management, cardiovascular disease, among many other chronic conditions at Loyola University Medical Center and Northwestern Memorial Hospital. Barbara’s professional focus is on behavioral interventions in disease management. She has contributed to multiple publications with her expertise in change activation, empowerment, and engagement.