Fasting good for diabetics?

Type 1 and LADA
1

Hi everyone,

First of all, let me tell you I've had T1 diabetes for just about 28 of my 38 years. I might be pretty lucky (?) in that I'm not much bothered by the disease, and live a very normal life. I added a question mark, as my relaxed attitude might come back and bite me later in life, who knows? My HbA1c are usually around 7-8.

What I wanted to tell you about - and indeed led me to this site, was fasting. No, I'm not a muslim, but I have a friend that introduced it to me about a year ago. What caught my interest was a YouTube video, a documentary from the BBC on fasting and it's benefits. Then there was another documentary on telly looking into the tradition of fasting in Eastern Europe. Very interesting. Sadly I cannot find the exact video links any more, but never mind that. The interesting bit, for me anyway, is to do with diabetes and fasting and these videos were not about that.

On the contrary, if you go and search for diabetes and fasting, you'll notice that there are many warnings against doing so. Why, I'm not totally sure of. Hopefully it's just that you risk getting too low or too high bloodsugar. If that is the case, then there has been no problem whatsoever in my case. The thing is, since I started this experiment 1 year ago, my values have been a lot better than they used to be. That goes for both HbA1c and daily levels. When I do fast, it's almost uncanny how stable the BS stays. I can literally go through a whole day with BS between 5 and 6. That's obviously not something I've been even close to before. As you well know, the balance between eating and taking the right amount of insulin is hard. To have 14 one moment, and 3 the next is quite "normal" to me. I'm not using a pump btw.

On a normal "eating day", I'm on 16 IE of the slow working Levemir morning and evening. Then I take 8-12 IE of quick working insulin for each meal during the day, usually 4 meals. When I fast, I'm cutting out the quick working one, but keeping the Levemir as normal. The actual fasting I'm doing, being aware that there are a few different types, consists of eating nothing at all, and only drinking water. Now, this sounds horrible, right? I thought so too, but I wanted to try it out for a bit of "fun". It turned out not to be so bad. Given that I take no meal-insulin, I'm not getting too hungry. Right now, I've not eaten since Sunday (around 65 hours ago), and I'm seriously not hungry. I do drink a lot of water though. Almost all the time.

I have to add that I have a pretty comfortable job, working as a developer for a software company. So it's quite relaxed. I would think this is essential, as I can imagine getting stressed up and/or moving around a lot at work would do something to the BS, so it might not be for everyone.

Usually I'm fasting for something like 3-4 days once a month. Sometimes only 24 hours. My latest HbA1c was 6,5. It's many years since it was that good and considerably better than last summer before I started this experiment, when it was 8. Given the very stable levels from my own testing, both day and night, it's a bit interesting to hear of anyone else having tried this kind of stuff?

One added bonus, and something I read about on another thread, was the testing. I've not been too good at that, and could easily go weeks without doing it. However when I do fast, I measure my bloodsugar all the time! It's fun to see that it's not moving anywhere :-)

OK, this is becoming too long now. Thanks for reading, and hopefully some of you have some experience you want to share.

Cheers,
Tony

2

I know this post is about fasting and I don't have opinions or knowledge on this topic. But my concern is that you might be using fasting to obtain good blood sugars, since it does have that result for you. What that means is that your basal is set right, because with good basal we should be able to go without eating and remain stable.

However, it seems to me that you still need to work on your D management aside from the fasting. A1C's between 7 and 8 are not great and can lead to complications. You say you rarely test when you're not fasting and that means it's amazing that you've not had even higher A1C's! Also, taking a "set dose" with meals, rather than figuring out an Insulin to Carb ratio to gear your dose to what you are actually eating is a setup for having both high and low blood sugars and overall mediocre management at best.

People fast for many reasons but controlling your D by fasting rather than doing the hard work of D management is not a particularly effective approach. This is, of course, just my opinion.

3

i am seriously considering IF lifestyle. I think we have talked about this before. What do you do if you are low during a fasting time? I usually use an apple or some berries to treat my lows...but wondering if that would throw off my fasting.

Has this helped with weight management? What is your fasting window.

THANKS!

4

I have been thinking this myself, that fasting might actually disturb the long term measurement (HbA1c) and "camouflage" the truth in a way. I really don't know. It's as I say, an experiment.

What I do know is that if I went completely without food all the time, everything would be great. Sadly not an option :-)

For now, I'd say my fasting is like sending my body on vacation! While I'm fasting everything is excellent, but when I'm eating it's back to every day life.

I was a bit quick with the dosages I guess. I definitely don't set a fixed dosage for every meal, but do my calculations each time. After almost 30 years you would expect that. However I don't really live very healthy and eat a lot of junk, so that is obviously not good at all. On the plus side I do a bit of running (except when I'm fasting that is).

5

I have fasted for spiritual reasons and have had no problems with BG. I don't think fasting for mutable days is a good idea for BG control and if you are working or driving it's unsafe for anyone, even a none PWD.

"breaking the fast" is the critical phase of fasting. While your body is in the resting mode, your stomach shrinks and your intestines become idle, so solid food must be re-introduced very slowly to avoid kidney failure or digestive distress, this is not a good idea for someone with stomach emptying problems and weakened kidneys..."like a PWD"...JMHO.

6

I agree with Zoe, I would work on controlling your bg first to get a lower a1c and then add fasting in after if you feel that will help you. Not testing when you're on insulin is dangerous, you could go low, high and really have no idea what the result may be, even more so than with tests.

I do not believe in fasting for more than a few hours, for any reason, but if that works for someone and doesn't hurt them etc. fine! I think it is better to just find out the pattern of meals and fasts in between that works best for you. More than a few hours and you can start to have metabolic issues etc.

7

I am a T2, but I am on insulin. I regularly fast. I believe it helps me with weight management, but I don't have strong evidence personally. There are a number of studies that show it works well for weight loss/management in non-diabetics. I firmly believe that fat loss occurs when we "burn fat." And fat burning occurs when we are fasting, have low insulin levels and our bodies demand energy (at a modest level). If you do IF under the right conditions, I believe you will walk around all day burning fat.

Beyond that, the two other reasons I do IF is that it mentally trains me to control my hunger and be mindful of eating and that it ensures I maintain a proper basal setting.

Lately, I have taken to doing IF "Fat fasts," starting my day with a "Bulletproof Coffee:"

Brian's "Bulletproof Coffee"

6-8oz of black brewed coffee
2 tbs butter (I use Kerrygold)
2 tbs Coconut Oil
1/8th tsp Vanilla Extract (Optional)
1 tbs sweetener (Optional, I use splenda)
other spices as desired

Then use a hand blender to mix it up. (450 calories, 50g fat, 0g carb, 0g protein)

8

Under fasting conditions, cells will breakdown glycogen stores, first, to maintain BG levels, then turn to gluconeogenesis from proteins once glycogen stores are depleted. Fat "burning" comes later, so it would take extended periods of fasting to start losing weight due to fat loss. In the meantime, in the absence of any other stimulation, metabolic rate adjusts down to help maintain both protein and fat stores.

I imagine you're benefitting from two additional things that help your intermittent fasting; your exercise program which helps keep your metabolic rate ramped up and helps maintain lean body mass, and your normal low carb diet which helps keep your glycogen stores chronically low as well as your your fat burning metabolic pathways ramped up.

9

Here's another good discussion on fasting
https://forum.tudiabetes.org/topics/diabetics-fasting