Intermittent fasting shows promise for those with type 1 diabetes
In her 20 years of studying intermittent fasting, Krista Varady has produced research that shows the weight-loss regime is safe for a range of people. Yet Varady has always cautioned against fasting for one group: people with type 1 diabetes.
So she was surprised when endocrinologists started asking her why she gave that advice. “Isn’t it unsafe?’” she’d respond, given that fasting can cause low blood-sugar levels. “And they’d answer, ‘Oh no, it should work just fine if the patient works closely with their doctor.’”
The endocrinologists based their belief largely on anecdotal evidence from their own clinics, she said. So Varady, a professor of nutrition at the University of Illinois Chicago, decided to team up with a group of endocrinologists to explore whether time-restricted eating is a good option for those with type 1 diabetes.
The researchers recently published a paper in Trends in Endocrinolgoy & Metabolism that suggests time-restricted eating would be safe and effective for those with type 1 diabetes. They also have started a pilot clinical trial at UIC to test this theory, which they hope to finish in about a year.
Time-restricted eating is a type of intermittent fasting where people can eat whatever they want for part of the day, such as from noon to 8 p.m., and then fast the rest of the day. To date, there have been no clinical trials of time-restricted eating for people with type 1 diabetes — Varady’s group’s will be the first — but there has been research on different types of fasting in this population.
Paper suggests fasting is safe for those with type 1 diabetes
For their paper, the researchers looked at seven fasting studies — all they could find for people with type 1 diabetes. The studies ranged from research on water fasting, where people have nothing but water for a day or two, to studies that tracked how those with type 1 diabetes fared while fasting for Ramadan.
Overall, they found there were no adverse reactions from fasting such as hypoglycemia or diabetic ketoacidosis. And in some studies, people either lost weight or lowered their average blood-sugar levels.
“It does seem like it has the potential to help,” Varady said.
Pilot study will shed more light
For the pilot study, the researchers will examine how time-restricted eating compares to calorie counting and to a control group for those with type 1 diabetes.
They’re planning to enroll 60 participants — 20 in each group — and use the results to get funding for a larger study. Dr. Sirimon Reutrakul, a UIC professor of medicine who specializes in diabetes care, is a coauthor.
This work builds off a recent clinical study by Varady and others that showed time-restricted eating is safe and effective at helping those with type 2 diabetes lose weight and control their blood-sugar levels.
Varady stressed that anyone with diabetes should consult their doctor before starting any type of fast. In the paper, the authors recommend considering factors such as glucose monitoring and insulin adjustments. Patients should be closely monitored for the first two weeks of a fast as their body adjusts to the changes, they add.
“People absolutely have to work with their doctors,” Varady said. “Don’t just start it on your own.”
The other authors on the paper are Mary-Claire Runchey at UIC, Alaina Vidmar at the University of Southern California and Lisa Chow at the University of Minnesota.
