Intermittent fasting may negate need for diabetes drugs, small study suggests | Hacker News Reader

Intermittent fasting may negate need for diabetes drugs, small study suggests

upi.com

43 pointssupermatou18 comments

That's a pretty long fasting interval:

"is a new proposed dietary approach based on [intermittent fasting] involving five fasting days followed by 10 days of reintroducing everyday food items."

And when they say "everyday food items" they apparently mean a special diet:

The diet contains daily foods such as wheat, barley, rice, rye and oat, "and features reduced glycemic loads, calories, and carbohydrates, as well as increased unsaturated fatty acids," the scientists said.

It doesn't appear that they tested a group that had the special diet but without the intermittent fasting.

5 fasting days doesn't mean 5 days of total fasting.

It does read to me like this means 5 days of total fasting. If the 5 fasting days were spread out, then what did the participating subjects eat on non-fasting days before the "everyday food items" were reintroduced?

I don't have access to the paper and couldn't find a preprint so I cannot check beyond what is in the UPI article.

It's probably a 5:2 fast—five days of intermittent fasting and two days of 500-600 calories [1].

On the fasting days, it could be 16 hours of fasting and an 8-hour feeding window (16:8 in the fasting lingo).

[1]: https://www.healthline.com/nutrition/the-5-2-diet-guide

If they are doing intermittent fasting, then why do they have to "reintroduce" foods during the 10 day feeding window, when they've been eating food every day?

These are probably foods that weren't allowed during the eating windows.

I don't have access to the full text either, but I'd be really surprised if it's five days of total fasting. I'd expect that it's low calorie days with some special restrictions (or even meals) they've set out.

I was skeptical and did some further reading, but it seems like there's other papers showing that diabetes is reversible with weightloss. In particular:

- This 2006 paper found that bariatric surgery can reverse diabetes: [2006]

- This paper reversed diabetes in people purely through calorie restriction: [2011]

- This survey article [2020] finds that about half (!) of diabetics who lose 15 kg totally reverse type 2, and no longer need any medication. It also proposes mechanisms for why this works.

I'm not a doctor or a medical researcher and don't have the skill to read these studies carefully. But it seems that it's generally known now that diabetes is reversible with dieting? Of note the 2020 article is a little stricter than TFA: it says that the HbA_1c threshold has to below 6.5% even after six months of no medication, while TFA defines it as three months. Given that the "only 2.8% of control group individuals achieved remission", it's possible that intermittent fasting only helped vis-a-vis weight loss, and as long as you lose enough weight you can potentially reverse diabetes.

It'd be nice if TFA was on sci-hub.

[2006] https://diabetesjournals.org/diabetes/article/55/7/2025/1419...

[2011] https://pubmed.ncbi.nlm.nih.gov/21656330/

[2020] https://www.bmj.com/content/374/bmj.n1449

I thought it was widely known that weight loss and carbohydrate/sugar restriction results in drug-free remission. People are addicted to fast sugar and are often eating themselves to death.

Without a doubt weight loss can mitigate the need for drugs, but diet works better in my experience. I eliminated my need for extraneous insulin in less than 4 months just by switching to a keto diet. When I was able to come off the drugs I was still morbidly obese and well over 400lbs. Significant weight loss followed, but the diabetes went into remission well before there was any significant weight loss.

I'm not seeing the reasoning behind intermittent fasting in particular as opposed to losing weight in general. Couldn't the title just have equivalently been "losing weight may negate need for [type 2] diabetes drugs"?

IF has an immediate effect on blood glucose levels and so insulin sensitivity quickly improves. Losing weight generally also improves insulin sensitivity but more slowly (blood glucose levels can stay high until significant weight loss has occurred)

Metabolic syndrome isn't so simple. You can sugary calories in small doses throughout the day, lose weight (through caloric deficit), and still develop insulin resistance because your body is constantly saturated in insulin. The theory behind fasting and T2D reversal is that your body is subjected to insulin (especially high insulin) as minimally as possible.

I have a friend who is a competitive seniors category swimmer, and has been competitive his whole adult (and adolescent) life. At the age of 60, after a lifetime of eating 6 small carb heavy meals a day to fuel his races he developed T2D. At the time he was 165lbs of lean muscle and he started wasting away. He has now eliminated all starchy/sugary carbohydrates and fasts 12 hours a day. He has reversed T2D, as long as he maintains the diet and fasting.

> eating 6 small carb heavy meals a day to fuel his races

That was the theory in 1980s, and has been largely debunked.

It just astounds me that they still insist on a diet of grains and other carbs for type-2 diabetes.

There's a big difference between type 1 and type 2 diabetes; this study focuses on type 2. It would be better if the HN title and the title on upi.com included "type 2".

It is sort of obvious, though. Type 1 diabetics require insulin because they cannot produce it. Fasting, of course, will not change that. They must take insulin.

I go breakfast-to-breakfast several times a month.

Feels great.

Little weight loss value, but still.

Reply on news.ycombinator.com