The FastDay Forum

We have a doctor who we have been seeing for nearly 20 years. I like him a lot and he is thorough and professional. However, he doesn't know everything.

My OH has type 2 Diabetes. He has been unable to lose any weight on this WOE, although, I should add that his idea of fasting is not as strict as mine. Any way he thought perhaps the drugs he was taking for the diabetes might be stopping him from losing weight. He discussed it with the doc and the doc has agreed to him stopping those drugs. Yes, he said, it's possible that they are contributing to his weight issues.

However, then he said, he didn't think the 52 Fast Diet was a good idea for diabetics because people with diabetes should be snacking regularly.

Is this true? Are there diabetic type 2 people on the forum who have successfully used the 52fasting diet, lost weight, and generally think it's a good idea for them to do it?

[carorees]

search for posts by @140lbs. She used 5:2 combined with a low carb diet to lose a lot of weight and come off all her diabetes meds.

I work as a nurse in a GP surgery and while I am certainly not an 'expert' it seems complete madness to me that a lot of doctors (and even Diabetes UK, which is supposedly full of up to the minute imformation about diabetes) are still telling people with diabetes to base their meals round starchy carbs when all the reading I've done since being on this WOE suggests that's the LAST thing they need. Being diabetic means that one's ability to metabolise carbohydrate and keep one's blood glucose stable has gone awry so why tell people to keep doing the thing that is making them have higher blood sugar when they could do much better NOT eating like that?? I think there are some clued up doctors out there but there are also those who aren't.

There is not a lot of studies on intermittent fasting and diabetes, so we cannot really say if it's a good idea for diabetic people to be on 5:2. I found one study examining effect of intermittent fasting on glucose sensitivity, but it is not even a human study. The study demonstrated that fasting resulted in improved glucose sensitivity and better insulin responsiveness. However, it is crucial to monitor blood glucose level throughout whole fasting days. The portions of meals during fasting days needs to be VERY small.


Belkacemi L, Selselet-Attou G, Louchami K, Sener A, Malaisse WJ. (2010) Intermittent fasting modulation of the diabetic syndrome in sand rats. II. In vivo investigations.Int J Mol Med.: 26(5): 759-65.
http://www.ncbi.nlm.nih.gov/pubmed/20878099

[carorees]

Back at my desk now!
In fact there have been quite a few studies on fasting with diabetes in humans:
This one examined the role of an 18 hour fast in people with diabetes and without and found that blood glucose dropped by a further 23% if the overnight fast is extended from 12 hours to 18 hours http://www.ncbi.nlm.nih.gov/pubmed/2202174
Use of intermittent fasting for prevention of diabetes: http://dvd.sagepub.com/content/13/2/68.full.pdf+html
There are many studies on fasting and diabetes in the context of Ramadan fasting. Here is one: http://www.ncbi.nlm.nih.gov/pubmed/23934679
And another with free full text: http://www.ncbi.nlm.nih.gov/pubmed/24089232
The Ramadan studies show improved glycaemic control during Ramadan when subjects are doing daily fasting.

What is missing is studies into 5:2 fasting and diabetes, but the above studies demonstrate that there is no intrinsic problem with fasting for type 2 diabetic patients.

Here are some previous threads on 5:2 fasting and diabetes here at the forum:
medical-conditions-f30/topic4940.html
medical-conditions-f30/topic1246.html

Lastly, This review of intermittent fasting studies by Krista Varady includes a section on animal studies of fasting and diabetes: http://ajcn.nutrition.org/content/86/1/7.full

And another post about Doctors. There's someone at work who is on the 5:2 for health reasons. She went to her doctor recently and was delivered a diatribe about how bad the 5:2 diet was for her health. She had blood tests. She returned to the doctor this week to learn that all her bloods had improved dramatically since the last time she had them done. The doctor didn't admit she was wrong but was somewhat abashed.

I know someone with diabetes who I am fairly sure is getting lousy advice from her doctor. I am fairly sure she has type 1.5 diabetes (also called latent autoimmune diabetes of adults (LADA)), basically an adult with diabetes more like type I, an autoimmune disorder, characterized by insulin dependence. She was overweight, but quickly got in under control. Instead of that making things better, she's gone from meds to having to inject insulin. Her dietary advice is bad, too. The doctor doesn't have her reducing carbs at all! She tends to be hypoglycemic every morning and has to keep something sweet around just in case. She gets prickly when I suggest she may have essentially a different disease. I'm afraid to bring it up anymore. If I"m right about the type 1.5, there's nothing that can be done about the insulin injections. However, if she keeps her blood glucose at a more constant, healthy level, she won't need it as often, and hopefully won't have the wild fluctuations.

More about type 1.5 diabetes here: http://en.wikipedia.org/wiki/Latent_autoimmune_diabetes

hi everyone, Hope your fasting days are going well (and the other ones too!). I thought I could post in this forum as I'm both a doctor and a diabetic! Type 2 for 13 years, well-controlled on low GI & exercise & metformin, but unable to lose much weight - until now! 6 weeks of 5/2ing and I'm already 7kg down. (Can't work out how to put that info under my avatar?)

But I have been having a slight issue with my blood glucose levels - they tend to go UP during the first hours of fasting, like up to 7.5 or so, which is really high for me. I know in one of Krista Veridy's studies, the women had increased insulin resistance, but haven't read of this anywhere else. Having said that, they do come down later in the day, to around 5, which I'm happy with. And I've also just had my HbA1c done, which has come back as 5.4 (36 new parlance) - normal. So I think it's possibly just an isolated thing, maybe to do with stress hormones and/or the "dawn effect". I've looked on the diabetes forums, but can't find anything about it. I don't have an endocrinologist to ask at this point. But just wondering whether anyone with type 2 out there has had a similar experience? Having said all that, during my fast yesterday, it didn't happen. Maybe it's just a bit of short-term pain for long-term gain (or loss!)? Any ideas?

Hi Jools and welcome,

It is lovely to have some doctors on here and I am interested in your remark about no endocrinologist to hand, well, one of our best friends is a consultant endocrinologist and he is horrified by 5:2 so I never discuss it with him. G.P.s in this country are not too savvy, in my opinion, about diet and nutrition and they are paid extra for every patient of theirs whom they diagnose as diabetic so I feel this can muddy the waters just a little.

Ballerina x

Hi Jools,

To get the info below your avatar, enter it into the progress tracker. It's in the gray menu bar along the top of the page, toward the right.

I was pre-diabetic and sliding quickly into Type 2. It was only by good luck and delaying my GP appts that I didn't end up with a full on argument about not going on metformin! It was before 5:2 and I got my BG down into normal levels by going low carb. If you look on diabetes.co.uk (No relation to Diabetes UK who still have their heads firmly entrenched in low fat/high carb) you will find lots of advice on managing BG with low carb.

I went onto 5:2 hoping that it would allow me to drop more weight and keep things stable whilst eating more carb but it wasn't going to happen. I went to 5:2 and low carb but still got dawn phenomenon so now I do LCHF (see Diet Doctor web site) and 16:8 and my BG is great again. My weight loss is very slow but I have other health issues that play a big part in that so I'm pretty well resigned to the fact that target weight is a long way away time-wise.

I don't know if the fact that 5:2 didn't suit was anything to do with the Type 2. I think it was more to do with my personal situation but I would heartily recommend low carb to get BG down.

[carorees]

Hi Jools

I think it's to do with excess gluconeogenesis occurring overnight causing a dawn phenomenon. I'm not sure anyone has really got to the bottom of why this occurs in some people but not others. Some say a handful of almonds or similar, while high in cals can give just enough carb to stop the liver making glucose. Do you get high bg on non-fast mornings too?

Possibly it's also to do with metabolic inflexibility which is worse in obesity and, of course T2D. Hopefully, as you reactivate those old metabolic pathways, your body will switch on fat oxidation more rapidly. You should also be aware that it is the morning after the fast where you may get higher glucose excursions after breaking your fast. Again, avoiding a carb based breakfast is a good idea...nuts or eggs are better. Generally cutting carbs and increasing fats will encourage fat oxidation, lower insulin and ultimately lower bg. You may be interested in reading the info on Peter Attia's site: http://www.eatingacademy.com as he is a surgeon who when he developed glucose intolerance despite following all the health advice to the letter, decided to self experiment and find out why. He discovered that a very low carb diet completely reversed the metabolic derangements. His site has a lot of great info about metabolism and endocrinology.

There is masses of info about the metabolic processes during fasting in the 5:2 lab.

Its a strange phenomenon. I still get it but as my fasting BG doesn't go over 6mmol now I don't worry about it. I did wonder if it was down to weird sleep patterns due to FMS. It's always worse if I've had a day where I've eaten more high GI carbs than normal. I can sometimes get away with a bit of extra carb if its not sugary. If I'm hungry at night I will have a small cheese stick with a hot drink before bed. I think they're about 20gr but some people find they do better with an oatcake. You have to experiment and see what suits you best.

My OH has type 2 Diabetes. He has been unable to lose any weight on this WOE, although, I should add that his idea of fasting is not as strict as mine.
...
However, then [the doctor] said, he didn't think the 52 Fast Diet was a good idea for diabetics because people with diabetes should be snacking regularly.

Really late to comment here but you should seriously take a look at the following book - most especially chapter 15. The book contains extensive sections and references in regard to successful low carb treatment of type 2 diabetes:

http://www.amazon.co.uk/Art-Science-Low ... ate+living

(My older brother died ~25 years ago from diabetes and I still miss him.)

Thanks ADFnFuel. I'll look that up. I'm sure you never get over losing a brother.