Therapeutic Fasting Could Be an Alternative to Insulin for Some Diabetes Patients

By Amy Orciari Herman

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

Medically supervised fasting could eliminate the need for insulin in some patients with type 2 diabetes, according to findings in BMJ Case Reports.

Three men who'd had type 2 diabetes for 10 to 25 years — and who were taking various pharmacotherapies, including insulin — underwent nutritional training and were instructed to fast for 24 hours three times a week for several months. On fasting days, they ate just dinner. On nonfasting days, they ate lunch and dinner. Low-carbohydrate meals were advised, and participants were seen twice a month for lab testing.

Among the findings:

• All three patients were able to discontinue insulin within 5 to 18 days. Two ultimately stopped all diabetes medications.

• All participants saw reductions in hemoglobin A1c, and none experienced symptoms of hypoglycemia.

• All three lost weight (10%–18% of body weight) and reduced their waist circumference.

• Patients described feeling "terrific" and "excellent" on fasting days.

The researchers write, "Educating patients on the benefits of fasting ... may aid in the remission of [diabetes] and curtail the use of pharmacological interventions."