Planned, intermittent fasting may reverse type 2 diabetes, suggest doctors in the journal BMJ Case Reports . This was after three patients in their care were able to cut out the need for insulin treatment altogether.
Findings from the three cases were published online, on October 9, by Dr. Suleiman Furmli of the Department of Family Medicine at the University of Toronto, Ontario, Canada, and colleagues.
Umbrella term
Intermittent fasting or intermittent calorie restriction is an umbrella term for various diets that cycle between a period of fasting and non-fasting during a defined period.
According to endocrinologists in India who agree that periodic fasting is a way of life in our country, this can be both beneficial and harmful for diabetics. While modifying lifestyles is key to tackling this non-communicable disease, diabetics should take medical advice before undertaking any “treatment”, they add.
Obesity and excess weight are the biggest risk factors for diabetes. Much of the harm caused by diabetes can be prevented or delayed by healthy eating and exercising regularly.
M. A. Shekar, Director, Karnataka Institute of Endocrinology and Research in Bengaluru, who approves of fasting as a tool to manage type 2 diabetes, says intermittent fasting has shown beneficial results in some clinical trials.
“But the numbers are very few. However, in some, it is determined that intermittent fasting can be harmful. The main outcome has shown that the positive result of fasting is weight loss,” he says, “The advice to fast should be individualised based on the needs of the individual patient. Most importantly, it should be socially, culturally and psychologically acceptable to the individual patient.”
‘Need more studies’
K.M. Prasanna Kumar, former President of the Endocrine Society of India and Research Society for the Study of Diabetes in India, says larger studies involving more diabetics are necessary to prove that intermittent fasting can reverse diabetes.
“The present report is an observational study done only in three patients,” he notes. “The study gives rise to many questions such as safety in the long term and whether this is applicable to only those with newly detected diabetes, mild diabetics or all persons with diabetes at all stages. Is fasting helpful for obese persons with diabetes and not for lean and overweight persons? How long will this effect last and can diabetes come back after going back to a normal diet? All these aspects need to be studied.”
Somashekara Reddy K.S., Secretary of the Karnataka Endocrine Society, says there are several studies to show that a diabetic can be healthier with exercise and reduced calorie intake.
India’s growing burden
According to the World Health Organisation, diabetes is a growing challenge in India with an estimated 8.7% diabetic population in the age group of 20 and 70 years. The rising prevalence of diabetes and other non-communicable diseases is driven by a combination of factors such as rapid urbanisation, sedentary lifestyles, unhealthy diets, tobacco use, and increasing life expectancy.
“India currently represents 49% of the world’s diabetes burden, with an estimated 72 million cases in 2017, a figure expected to almost double to 134 million by 2025. The prevalence of diabetes has increased by 64% across India over the quarter-century,” according to a report published in November 2017 by the Indian Council of Medical Research, and conducted with other organisations.
yasmeen.afshan@thehindu.co.in
