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Fasting with Medical Conditions

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5:2 and diabetes type 1
19 Feb 2013, 19:51
Hi everyone. I'm new here - I've been reading/hearing about this diet for a while now and am really keen to try it (or at least a version of it) but I am a type 1 diabetic and - surprise, surprise - it is 'not recommended' for me to do this diet.

The thing is that I used to love fasting, I used to enjoy the focus it gave and also watching the hunger pangs come and go was quite interesting. When I became diabetic (quite late for a type 1 at 15 years old) I had to eat whether I wanted to or not... 3 meals a day, compulsory snacks if I have a hypo... which I hate. Don't get me wrong - I will eat bad foods far too often just like any ordinary person, but then I'll get days when I just don't want to eat much, if anything.

As well as this, and prob the main reasons I want to do it, I am a bit overweight since having kids (particularly my twins 11 months ago - I'ma whole dress size up) and my blood sugar control is really not great. So I feel rubbish all the time. I really want to feel better, fitter and have more energy. It's a bonus to look slim, but it's much more about feeling healthy.

So anyway, I was wondering if there were any diabetics out there who had any experience with this, or anyone else who'd like to offer some advice? I reckon it shouldn't be too hard to work out a way of reducing my medication on fast days.

Thanks in advance :)
Re: 5:2 and diabetes type 1
19 Feb 2013, 21:01
Hi lemele and welcome.

This is a tricky one.

Do you adjust your own medication according to bg readings? That would be essential as the insulin would need some fine adjustment.

The thing is you need to consider not only insulin at mealtimes but basal insulin too. If you read up on how a non-diabetic person responds to fasting you will see that insulin levels fall in order to allow lipolysis. You really need to match your insulin levels quite precisely to allow ketone production as bg falls. But as you know this is not so good in diabetes. During fasting the circulating free fatty acids oppose the action of insulin so you would need a slightly higher insulin dose (relative to your carb intake) at meal times. Unfortunately we have no guidelines as to how much these adjustments should be.

The fact that your bg is not well controlled is worrying. How do you respond to the overnight fast? Do you get the "dawn phenomenon"?

I think you would need to monitor things very very closely.

Personally, I would not recommend you try it unless you can get your diabetes care team on board.

On the up side, fasting has historically been used to control diabetes and if you could work out the right adjustments it would be a good thing. It's just so difficult to manually make the adjustments that your body ought to make automatically. We don't really understand exactly how fasting affects different people who don't have diabetes let alone those who do.

There are a couple of docs who visit the forum who may have some thoughts but I would expect them to warn against it.

Sadly, I think we need a lot more research before fasting could be recommended for type 1 diabetes.

Best wishes
Re: 5:2 and diabetes type 1
10 Mar 2013, 09:41
Hi Lemele
Was very interested to find your post and the associated reply thank you carorees for actually giving a considered answer rather than just saying 'No' to 5:2 for type 1's. It has given me a bit more confidence that what I'm doing is OK.

I was first diagnosed with Type 1 diabetes at the old age of 28 (now 41), and being stubborn, do not like to be told I can't do something because of my condition! So I decided to try 5:2 fasting - but sensibly and in a very controlled manner.

I religiously, daily, persistently and successfully manage my diabetes with the DAFNE regime - Dose Adjustment For Normal Eating, I would really recommend you get yourself DAFNE trained first. Its not easy to get on the course, there were waiting lists in my healthcare area, and it was only that I had got to meltdown stage with my diabetes (crashing hypos, mum with 2 young kids, and the more I tried to control hypos without the knowledge and understanding I now have, the worse I made everything) that I managed to get onto the 5 day training course. It was the course that changed my life, I now understand how to adjust my basal insulin and check if I have the dose correct, how to correct highs and lows, and to calculate how much insulin I actually need for whatever I want to eat - and I really can eat anything now without highs or hypos.

So, armed with this knowledge, I started fasting around 3 weeks ago. I find that I adjust my basal insulin down by a unit on the night before a fast day, and during the fast day just inject as normal according to my foods carbo content. I check my blood sugars at least 4 times a day as usual and adjust if necessary according to the DAFNE rules. I have lost around 2kgs (I started at 60kgs and my BMI 24) and on the fast days have bags of energy and though still feel pangs of hunger get through them with tea with a dash or milk or bubbly water!

So I would really get yourself to a place where you can control your diabetes a bit better (I's be happy to help you with the basics of DAFNE while you get yourself on a course), you'll find you loose weight anyway initially when DAFNEing, and then consider the 5:2.

I would really like to hear from any other Type 1's out there fasting.

All the best
:clover:
Re: 5:2 and diabetes type 1
27 Mar 2013, 19:46
Hello all. I too am a type 1 Diabetic and I have been on 5:2 for 4 weeks and have completed 8 days of fasting as I type! I have also taken part in the DAFNE course which has been very helpful. I've found that reducing the morning and evening basal insulin injections allow me to fast without suffering from low blood glucose levels. I stick to the normal carb counting when taking my quick acting insulin, which is obviously heavily reduced on a fasting day. I have managed to shift 4 pounds so far. Im a 6ft 3 23yr old Male, hoping to cut down to around 14 stone (Currently 15.2). So far I absolutely love this diet/way of life!
Re: 5:2 and diabetes type 1
07 May 2013, 01:26
Hi Lemele,

My daughter Jen is type 1, too. She also got it late, aged 16 (now 21). She's interested in trying 5:2 (her dad and I have just started a few weeks ago), although it's not 'officially' recommended, as you say.

She feel, however, that she often 'naturally' does fasting days anyway. She has very erratic control (she also has lupus, which screws things up royally), and often has a poor appetite. She's found that her BGLs are usually steadier and better on 'low food' days, and her insulin needs are less. She is on an insulin pump.

Her experience is that as long as she's keeping a close eye on her BGLs, with regular testing through the day as if she was eating normally, it seems to be OK. But her situation is complicated with other conditions.

You might want to reduce your basal rate on fasting days.

There must be low cal hypo foods out there, but that aspect is a bit tricky. Basically, the diabetes comes first, if you get a hypo, you must treat it (obviously!).

And she says HI! She always likes meeting other Type 1s :)
Re: 5:2 and diabetes type 1
07 May 2013, 08:01
There must be low cal hypo foods out there, but that aspect is a bit tricky.


10-15g of glucose tablet is 40-60 cals so not a disaster if needed.
Re: 5:2 and diabetes type 1
08 May 2013, 08:57
Hi all you type 1 diabetics,

I'm a 45 year old mother of 2, type 1 for 25 years, who also read the book excitedly and then totally deflated when I got to the, 'who shouldn't do this diet' bit', so I'm so so pleased to see this thread. I'm on a pump, have done DAFNE, and so can't see why I can't fast without a bit of thought and care behind adjustment of basal rates and lots of testing throughout the day. It's just like a very low food day after all? I agree that having done DAFNE makes it all a lot easier and any diabetics that can get onto a DAFNE course should asap, regardless of whether they do this diet or not. Also anyone lucky enough to have a pump knows that basal and bolus rates can be changed within seconds to accommodate new circumstances such as exercise, sickness etc, so eating less for a day shouldn't be any different. It might be more of a faff to work out reducing basal rates if on long acting insulin via pens as you can't 'go back' but not impossible. I'm planning to start my first fast on Monday, so will let you know how it goes.
Re: 5:2 and diabetes type 1
08 May 2013, 16:37
I am a 33 year old type 1 diabetic (diagnosed at 9yrs) and I found this forum when I typed in 'type 1 diabetic fast diet' as I was looking for information specific to those with the condition. Like everyone else here I have read the book and wasn't at all surprised to find that T1 diabetics are one of the groups for whom it is not recommended (hardly a shock considering we're also not supposed to use foot spas or join gyms without checking with a medical professional...!)but I was sure that Google would help me and it did!
One of the great things about the FD is that I think it comes quite naturally to most of us - who hasn't thought 'I've had a weekend of non-stop eating, I'm going be very careful for a couple of days this week'? The concept of fasting is also not particularly unusual for diabetics - fasting blood tests or even days when my blood sugars have been really high and I've reduced them with insulin management and very careful eating. I'm now on an insulin pump and find that it's very compatible with the FD as I can adjust my own bolus and basal rates and on my fasting days (and the day after, interestingly) have excellent glucose readings. It does require pretty constant monitoring (but then the pump does anyway - that's the pay-off for such great blood sugar levels) but I feel great, have more energy and have lost weight. I will discuss it with my medical team (I haven't yet - I've been used to managing my own insulin / diet for years, very successfully) and will interested to hear what they say.
Good luck to everyone giving it a go.
Re: 5:2 and diabetes type 1
11 May 2013, 09:56
diabeticfaster wrote: I am a 33 year old type 1 diabetic (diagnosed at 9yrs) and I found this forum when I typed in 'type 1 diabetic fast diet' as I was looking for information specific to those with the condition. Like everyone else here I have read the book and wasn't at all surprised to find that T1 diabetics are one of the groups for whom it is not recommended (hardly a shock considering we're also not supposed to use foot spas or join gyms without checking with a medical professional...!)but I was sure that Google would help me and it did!
One of the great things about the FD is that I think it comes quite naturally to most of us - who hasn't thought 'I've had a weekend of non-stop eating, I'm going be very careful for a couple of days this week'? The concept of fasting is also not particularly unusual for diabetics - fasting blood tests or even days when my blood sugars have been really high and I've reduced them with insulin management and very careful eating. I'm now on an insulin pump and find that it's very compatible with the FD as I can adjust my own bolus and basal rates and on my fasting days (and the day after, interestingly) have excellent glucose readings. It does require pretty constant monitoring (but then the pump does anyway - that's the pay-off for such great blood sugar levels) but I feel great, have more energy and have lost weight. I will discuss it with my medical team (I haven't yet - I've been used to managing my own insulin / diet for years, very successfully) and will interested to hear what they say.
Good luck to everyone giving it a go.


It seems I am the only non-pumper with Type 1 doing 5:2, anyone else out there?
Re: 5:2 and diabetes type 1
11 May 2013, 10:39
you could try searching for "intermittent" at http://www.diabetes.co.uk/diabetes-forum/search.php

pops up a few hits.

Do pumps have continuous analysers, or do pumpers still do finger prick tests if they need to know their blood sugar number ?
Re: 5:2 and diabetes type 1
11 May 2013, 11:26
My OH was diagnosed very late (38) and has been insulin dependent for about 8 years. I don't think he wants to do 5:2 but he is looking into the DAFNE programme as, although he had heard of it, he wasn't sure how good it was. We found all your info very interesting.

Good work people!
Re: 5:2 and diabetes type 1
13 May 2013, 06:25
PhilT wrote: Do pumps have continuous analysers, or do pumpers still do finger prick tests if they need to know their blood sugar number ?


In general you still have to do frequent finger prick tests. You *can* get continuous blood sugar monitors, but they are expensive (well, they are in Australia, anyway!). Still new / developing technology.
Re: 5:2 and diabetes type 1
18 May 2013, 08:38
I've done the first week of the 5:2 and all is well so far. I reduced my basal on the pump throughout both fast days and put it up again on non fast days. I've already lost 4 pounds this week. I did find that my bg levels were lower than usual the day after the second fast and had a hypo in the afternoon, but now wonder if that's because I've lost weight and need less insulin for my weight? I'm also still interested what the medical reason is behind doctors saying this isn't for type 1 diabetics. Is it simply because recalibrating insulin input is tricky and could lead to hypos etc, or is there a more complex reason to do with ketones or something.
Re: 5:2 and diabetes type 1
20 May 2013, 02:48
Good questions! I've found that most doctors I mention it to (like my immunologist - I have an auto-immune disease, not T1D - my daughter has T1D, tho) are like "Woah, that sounds extreme, I don't know about that!" ... so I suspect they're over-reacting. If you're good at managing your insulin delivery and basal rates, why not ...

But I'll ask our ONE doctor who *does* know about 5:2 (and who is very supportive), about what he thinks about T1D + 5:2.
Re: 5:2 and diabetes type 1
20 May 2013, 09:08
I have never joined a forum but thought this one had some very helpful comments.

I've been a type 1 for 47 years (with an identical twin who's been type 1 for 51 years). My BMI is 25 so I must do something about it.

I'm not on a pump and have done DAFNE.

Today is my first day and I'm excited about doing this.

I had not thought about the basal insulin and only do it once a day (at night). Should I change that to twice? Maybe it is a little early to say.

The other issue is more diet-related. I do not eat much dairy (only milk) so any suggestions about what would be good, particularly for the morning meal?

I also get the "dawn effect" - blood was 8.1 at 06:00 this morning and 11.4 at 08:00 when I had breakfast. I will be keeping a close eye on blood all day but any thoughts would be appreciated.

Thank you.
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