Intermittent Fasting for Diabetes?
Intermittent fasting for diabetes is a trending eating plan which divides time into "fasting" time and "eating" time. The simplest example might be eating only between 8:00AM and 6:00 PM, then fasting until 8:00AM the next day. But the options are many. This eating pattern has shown some success, but there are some important things to watch out for.
Lifestyle interventions, healthy eating, being active, monitoring your blood sugar, taking medications as prescribed, are keys to managing diabetes. Changes to eating and physical activity can help with weight loss. We have seen positive results from the Diabetes Prevention Program were losing 5% of body weight effectively prevented pre-diabetes from moving into a type 2 diabetes diagnosis.
Choosing the right eating plan is more than just “how much weight can I lose fast?” We want to make sure the eating plan helps lower cholesterol and triglyceride levels, lowers blood pressure, and lowers blood sugar. And very importantly, is easy to stick to. In today’s video, we will review a trending eating plan called intermittent fasting and how it affects diabetes management.
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When you are looking at changing any of your lifestyle behaviors, make sure to check with your diabetes educator and medical team. And make sure to define the type of plan you will follow.
Preparing for Intermittent Fasting
With intermittent fasting, there are several levels. There is an 18-20 hour fast, eating during a 4-6 hour period of the day or 16-20 hours fast, eating 4-8 hours per day OR an alternate or consecutive day fasting. And, how are you defining your fasting? Is it no food or beverage?
If you choose to try a fasting regimen, there are four situations to be aware of and be prepared for:
- Low blood sugar levels which are defined as a blood sugar of 70 or lower
- High blood sugar defined as a blood sugar above your target or above 300
- Diabetic ketoacidosis happens when there is a lack of insulin; people with type 1 diabetes are at the greatest risk. And...
- Dehydration- this can occur rather quickly if you are limiting your intake of both food and beverages and if you are physically active, in hot weather, or perspiring a lot. When you become dehydrated, you also may see higher blood sugar readings.
The research shows some positive results in reductions in body weight when people ate for a 10-hour window which could equal, eating from 8 am until 6 pm and then fasting from 6 pm until 8 am the next morning. The researchers believe there was a movement of fat stores responsible for weight loss in this time period. Frankly, this seems a more reasonable approach to me than much longer fasting periods, especially as a starting point.
Is There Key Take-Aways to Intermittent Fasting for Diabetes?
I have four key take always, if you do consider following a fasting program:
Check
Check, check, check your blood sugar whether it is via a blood glucose meer or a continuous glucose monitor. You can’t assume nor go by how your body is feeling at all times. Recommendations are to check at least 4 times per day and of course, if you feel a below target or above target reading, check so you can treat the reading accordingly.
Hypoglycemia
If your blood sugar drops to 70 or below, please make sure to treat the low reading. Fast-acting carbohydrate is the best choice. Check out my video that offers food options to treating a low.
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Hyperglycemia
Also known as, elevated blood sugar- if your blood sugar is 250 or above, check for ketones, drink at least 8 oz of water over the hour, and take your medications as prescribed by your doctor.
For instance, those of you who may have type 1 diabetes, may have been given a correction factor which tells you how many units of insulin you should take to help lower your out of target reading. I also need to note here that research has not studied people who require insulin.
Side Effects With Diabetes Medications During Fasting
And if you are on diabetes medications that have a side effect of lowering blood sugar directly like insulin or sulfonylureas like glimepiride, glipizide or glyburide watch your blood sugars very carefully and speak to your doctor if changing in dosing is needed to help prevent lows.
There is also a class of medication called SLGT2 inhibitors (Invokana, Farmiga, and Jardiance) that won’t cause hypoglycemia but can increase your risk for dehydration or diabetes ketoacidosis if you are limiting your beverage intake. Again, check with your doctor about any changes in your medications. And, please, please, check with your doctor if you are on any high blood pressure medications. Physicians warn it is not safe to follow along fast while on hypertension lowering medications.
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A healthy eating plan and being physically active certainly are two important strategies for blood sugar management. If you decide to make any changes to your current regimen, make sure to inform your diabetes educator and doctor. And make sure to use the tool of blood sugar monitoring to see how your body is reacting to any new lifestyle behaviors.
Until next time, cheers to your health.
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