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type 2 diabetes with intermittent fasting - water glasses

Don’t you love it when it seems as though health professionals can’t agree on stuff? This idea of reversing type 2 diabetes through fasting or other methods happens to be one of those situations. If you were to ask 100 endocrinologists, nutritionists, and dietitians whether type 2 diabetes can be reversed, you will probably get a fairly even split of those saying “yes, it’s possible” and others saying no. At this point, I happen to align with the latter. As more studies are performed, my mind my change of course (it wouldn’t be the first time!).


Listen to Dr. Neal address this topic on Episode 490 of the podcast Optimal Health Daily.


Type 2 Diabetes Can Be Controlled

Here’s my rationale: Type 2 diabetes can be controlled so well that it seems as though the disease has gone away.

How could we possibly know this? Diabetes is diagnosed through a simple blood test; doctors look at how much sugar is in the blood. The higher the sugar levels, the more likely it is the person has diabetes. Once blood sugar levels go past a certain threshold, doctors will often prescribe medications (like insulin) to help control these levels. Of course, lifestyle changes will also be recommended like making dietary changes, exercising, and managing stress.

There seems to be some cases where patients who have been diagnosed with type 2 diabetes do so well with their lifestyle changes, that the doctor may take them off their medication. It’s as though the body can control its blood sugar levels on its own again–it appears that the disease has gone away. This is most often seen when someone has lost a significant amount of weight.

Can we safely say the disease has been reversed?

Not so fast, Kemosabe. I would say, in this scenario, the disease is being “controlled.” As time goes on, diabetes may get worse, even when the person is doing everything right to control the disease. For some reason, the body just does not respond as well.

Let’s say the person has been carefully watching her diet, exercising regularly, and managing her stress–her blood sugar levels may start to look normal again. But, over time, even though the patient has been continuing to perform these healthy behaviors, blood sugar levels start to creep back up again. We would say these blood sugar levels are not being controlled.

Why does this happen? No one is really sure, but the theory is that the person’s genetic make-up has changed. As a result, the body is no longer able to metabolize sugar as well and now, the body will always need some extra help (like medications) to manage that sugar.

Type 2 Diabetes and Intermittent Fasting

While I would disagree that intermittent fasting could reverse diabetes, I would say it’s possible that it may help control it. Intermittent fasting basically refers to having longer gaps in time between meals. Some intermittent fasting programs suggest limits on how many calories you can eat. For example, some may allow one meal during a “fasting day” that makes up 25 percent of your calorie needs for a typical day. So if you need to consume 2,000 calories per day, this would mean that your one meal should be about 500 calories.

In general, there are 3 types of intermittent fasting diets:

  1. Alternate-day fasting – This diet has you alternate between days you can eat what you want and days you are supposed to fast.
  2. Whole-day fasting – Fast one to two days per week; on the other days you can eat anything, anytime.
  3. Time-restricted eating – This involves a routine where you only have a certain number of hours to fast and a certain number of hours to eat daily.

There are some studies that have found benefits, such as weight loss, reduced body fat, and lower total cholesterol levels.

Here’s what’s important

If intermittent fasting can help reduce body weight in the short-term, it isn’t all that surprising that blood sugar levels will also improve. Like I mentioned earlier, when patients with type 2 diabetes lose weight, their blood sugar goes down. So is intermittent fasting really helpful, or the fact that it leads to weight loss? This is important to consider because, if a person is able to lose weight in other ways, like following a Mediterranean-type diet, then wouldn’t their blood sugar levels improve as well? They sure will! This is exactly what researchers are finding.

We also want to be very careful recommending a fasting diet to those with diabetes–particularly those on blood sugar-lowering medications. Think of it this way: if a person is taking medications to lower their blood sugar levels, and they don’t eat for long stretches of time, their blood sugar levels can get so low, they may pass out! Low blood sugar levels are far more dangerous in the short-term when compared to having high blood sugar levels.

The Bottom Line

Right now, it seems as though diabetes is a progressive disease. What may work to help control blood sugar levels today, may not work tomorrow; however, the disease can be controlled through proper lifestyle changes. But again, it can come back. Lastly, I would be cautious recommending an intermittent fasting diet for someone with diabetes, so that they don’t run the risk of having their blood sugar levels get too low.

Listen to Dr. Neal address this topic on Episode 490 of the podcast Optimal Health Daily.

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Neal Malik

Dr. Neal Malik ("Dr. Neal") has a Doctorate in Public Health with emphases in disease prevention and nutrition. He is also a Registered Dietitian and Certified Health Education Specialist. He is currently an assistant professor at California State University, San Bernardino. Dr. Neal has published peer-reviewed scientific research and been featured as a nutrition and wellness expert in over 70 media outlets including Parade and The L.A. Times.Send in your health related question and Dr. Neal will answer it on the Optimal Health Daily show!
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