There's been a lot of interest in intermittent fasting recently, and proponents firmly believe that it is good for your general health. But if you're Diabetic, is this a good plan for you?

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IS FASTING GOOD FOR

MY DIABETES?

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Regular fasting is known to improve your Insulin sensitivity, and it also helps you maintain a healthy weight. This reduces your risk of developing Diabetes in the first place, and it also helps you manage your Diabetes if you already have this medical condition.

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However, fasting can lead to fluctuations in your blood sugar levels if you are Diabetic, with the worse outcome being that of you having a low-sugar episode (hypoglycaemia) since your glucose metabolism is abnormal.

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Fasting will help you stay trim and fit, and manage your Diabetes better, but it can also be problematic for certain people.

 

The key here is to look at a few factors about yourself and your Diabetes, and then speak to your doctor about whether you should be doing regular fasts.

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IMPORTANT FACTORS

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Some factors about your Diabetes put you at a higher risk of a hypoglycaemic episode. 

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If you've had Diabetes for a very long period, such as more than 10 to 20 years, your Insulin hormone system may become insufficient to meet your body's metabolic needs over time.

 

This is largely due to the Insulin Resistance that contributes to your Diabetes, so your pancreas (an organ in your abdomen) has to work harder to secrete more Insulin. This secretion may become insufficient after a prolonged period of your pancreas being 'overworked'.

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If you've had a few hypoglycaemic episodes in the past, you're at a higher risk of developing another one. Fasting may not be such a good idea for you, since it's already known that you are indeed already at a higher risk of getting another episode of hypoglycaemia.

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If you're unwell, with an infection (like a flu, or food poisoning, or a skin infection), you should not be fasting. The infection itself will make your blood sugar control go a little haywire, and most people do not have much of an appetite when they're unwell, so the risk of developing hypoglycaemia is higher. Fasting will increase this risk.

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Some Diabetics will need to be on Insulin injections. This helps them control their Diabetes better than oral medications can. People on Insulin injections are at a higher risk of developing hypoglycaemia, especially during their fast. It's not such a good idea for these people to fast!

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WHAT MEDICATIONS SHOULD I BE

CAREFUL WITH?

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There are lots of medications that DIabetics may be on to help control their blood sugar, but there are some that you need to take special care with if you're Diabetic and plan to fast.

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METFORMIN - this medication reduces glucose absorption and improves Insulin sensitivity a bit. It's a low risk medication, so it should be alright to continue this while fasting if you're dose isn't too high.

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GLIPIZIDE - this medication stimulates your pancreas to release more Insulin. This medication is a HIGH RISK medication. You should definitely omit it during your fasting period.

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SITAGLIPTIN, LINAGLIPTIN - these medications increase your body's Insulin  secretion. Unlike Glipizide, it has a lower risk of causing hypoglycaemia. However, this type of medication has a glucose-dependent mechanism of action, so you can still skip it during your fasting period, since it may not do very much since you won't be taking any glucose in whilst fasting.

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ACARBOSE - this medication hampers the digestion of the carbohydrates in your meal. It is at a low risk of causing hypoglycaemia, but is also something that you can skip during your 'fasting window', since there isn't a need for this medication if you're not eating any carbohydrates.

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DAPAGLIFLOZIN - this medication acts on the kidneys to make them excrete more glucose in your urine. This medication also may not have very much effect when you're fasting, so although the risk of hypoglycaemia is low, there isn't much need to take it during your 'fasting window'.

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INSULIN INJECTIONS - this medication lowers your blood sugar levels directly. It is a HIGH RISK medication, and it is definitely not a good idea to fast whilst on Insulin.

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BLOOD PRESSURE MEDICATIONS: Some medications known as ACE-inhibitors or Angiotensin Receptor Blockers can cause a kidney injury if you become dehydrated. Some common examples of these medications are Enalapril, Losartan and Telmisartan. Other blood pressure medications can cause your blood pressure to dip too low if you don't maintain your fluid intake. Some examples are medications like Atenolol, Amlodipine, Lasix and Hydrochlorothiazide. Make sure you stay hydrated if you are on blood pressure medications!

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ON STANDBY

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Your main concern with fasting as a Diabetic is that your blood sugar levels may drop dangerously low during your 'fasting window'.

 

Keep a sugary snack on standby, like some sweets, along with some slower-digesting carbohydrates like biscuits.

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If you feel giddy, have cold sweats, or feel like you're about to faint, you should try to quickly check your blood sugar if you can. A reading below 4 mmol/L indicates your blood sugar level is too low, and you should quickly take your snack, and see a doctor. 

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If you don't have a glucometer on hand, you should take your snacks anyway, then see a doctor to get your blood sugar and blood pressure checked.

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WRAP IT UP!

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Regular fasts have a lot of health benefits to offer. However, if you are Diabetic, it may be more prudent to follow a different dieting routine. If you still want to try doing a regular fast, do check in with your doctor to see if it's safe for you to fast, and also if there's a need to adjust your medications. Remember to keep your snacks on standby in case you get a hypoglycaemic episode!