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Review
. 2023 Aug 10;15(16):3525.
doi: 10.3390/nu15163525.

Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review

Daniel Herz  1 , Sandra Haupt  1 , Rebecca Tanja Zimmer  1 , Nadine Bianca Wachsmuth  1 , Janis Schierbauer  1 , Paul Zimmermann  1   2   3 , Thomas Voit  1 , Ulrike Thurm  1 , Kayvan Khoramipour  4 , Sian Rilstone  1   5 , Othmar Moser  1   6
Affiliations
Review

Efficacy of Fasting in Type 1 and Type 2 Diabetes Mellitus: A Narrative Review

Daniel Herz et al. Nutrients. .

Abstract

Over the last decade, studies suggested that dietary behavior modification, including fasting, can improve metabolic and cardiovascular markers as well as body composition. Given the increasing prevalence of people with type 1 (T1DM) and type 2 diabetes mellitus (T2DM) and the increasing obesity (also in combination with diabetes), nutritional therapies are gaining importance, besides pharmaceutical interventions. Fasting has demonstrated beneficial effects for both healthy individuals and those with metabolic diseases, leading to increased research interest in its impact on glycemia and associated short- and long-term complications. Therefore, this review aimed to investigate whether fasting can be used safely and effectively in addition to medications to support the therapy in T1DM and T2DM. A literature search on fasting and its interaction with diabetes was conducted via PubMed in September 2022. Fasting has the potential to minimize the risk of hypoglycemia in T1DM, lower glycaemic variability, and improve fat metabolism in T1DM and T2DM. It also increases insulin sensitivity, reduces endogenous glucose production in diabetes, lowers body weight, and improves body composition. To conclude, fasting is efficient for therapy management for both people with T1DM and T2DM and can be safely performed, when necessary, with the support of health care professionals.

Keywords: Ramadan fasting; diabetes mellitus; fasting interventions; intermittent fasting; periodic fasting; time-restricted fasting.

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Conflict of interest statement

The authors have no relevant competing interest pertinent to the topic to disclose.

Figures

Figure 1
Figure 1
Representation of circulating glucagon and insulin in fasting periods. Taking the circadian rhythm into account, various endocrine factors are determined by diurnal fluctuations. These fluctuations are important for physiological processes to occur at the optimal time of day. Fasting already leads to changes in glucose and lipid metabolism in the first 48 h by promoting either catabolism with fatty acid oxidation and glycolysis or anabolism with lipogenesis and glycogenesis.
Figure 2
Figure 2
Physiological mechanisms involved in the health effects of fasting. The lower semicircles refer to the relative effect of fasting on the different metabolic pathways involved. The upper semicircle represents the relationship between the circadian rhythm and some individual physiological effects at a given time of day within 24 h.
See this image and copyright information in PMC

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