Seven-day Fasting as a multimodal complex intervention for Adults with Type 1 Diabetes – Feasibility, Benefit and Safety in a Controlled Pilot Study
Aims/Hypothesis: Intermittent as well as prolonged fasting are receiving considerable attention and appear favorable in conditions like the metabolic syndrome, type 2 diabetes, rheumatic diseases and others. Fasting for people with type 1 diabetes is generally considered too risky. However, the ability and possibility to change from carbohydrate to ketone-based fuel supply may also be relevant for people with type 1 diabetes. The aim of this patient-led research was to investigate the feasibility, benefit and safety of a seven-day multimodal fasting intervention in people with type 1 diabetes.
Methods: A non-randomized controlled pilot study, with 20 participants with and 10 without type 1 diabetes with data acquisition toking place prior, post and four months after the intervention and daily during intervention.
Results: 29 of 30 participants finished the intervention. Mean ß-hydroxybutyrate as representative ketone body increased to 2.8 ± 1.9 mmol/L on day 7 while average glucose remained between 4.9 ± 1.5 to 7.5 ± 2.3 mmol/L89 [± 27 and 136 ± 40 mg/dL]. Fasting-related side effects were all temporary, and slightly more prevalent in those with type 1 diabetes. Mean daily insulin dose was adjusted from 24.4 (3-50) IU on the day before fasting to 7.6 (0-26.7) IU on day 7. Quality of life (WHO-5) normalized from 54.0 ± 4.4 to 68.8 ± 15.0 (p = 0.01) after fasting. The was a decrease from before until the follow -up four month late of weight from 77.6 ± 20.4 kg to 76.6 ± 20.9 kg (p = 0.023) and for the BMI from (27.68 ± 7.04) to (26.74 ± 7.15) kg/m2 (p = 0.008). Diastolic blood pressure increased from 69.75 ± 11.41 mmHg to 75.74 ± 8.42 mmHg (p = 0.028) and stayed in a healthy range on average.
Conclusions/Interpretation: This study demonstrates the feasibility, benefits and safety aspects of a 7-day fast in adults with type 1 diabetes.
This is a list of supplementary files associated with this preprint. Click to download.
FaMeD1_Figure 2 Time Table
FaMeD1_Figure3_ Ketone bodies and Glucose
FaMeD1-Figure 4 _ Ketone body development under fasting
FaMeD1- Figure 1 Flow Chart
I fasted 2 weeks ago for 5 days and from day 3 on without insulin. I am a Typ 1 diabetic for 24 years now. It is a great feeling to live without insulin. Even if it's only for a couple of days...
On 22 Jan, 2021
Posted 19 Aug, 2020
Seven-day Fasting as a multimodal complex intervention for Adults with Type 1 Diabetes – Feasibility, Benefit and Safety in a Controlled Pilot Study
On 22 Jan, 2021
Posted 19 Aug, 2020
Aims/Hypothesis: Intermittent as well as prolonged fasting are receiving considerable attention and appear favorable in conditions like the metabolic syndrome, type 2 diabetes, rheumatic diseases and others. Fasting for people with type 1 diabetes is generally considered too risky. However, the ability and possibility to change from carbohydrate to ketone-based fuel supply may also be relevant for people with type 1 diabetes. The aim of this patient-led research was to investigate the feasibility, benefit and safety of a seven-day multimodal fasting intervention in people with type 1 diabetes.
Methods: A non-randomized controlled pilot study, with 20 participants with and 10 without type 1 diabetes with data acquisition toking place prior, post and four months after the intervention and daily during intervention.
Results: 29 of 30 participants finished the intervention. Mean ß-hydroxybutyrate as representative ketone body increased to 2.8 ± 1.9 mmol/L on day 7 while average glucose remained between 4.9 ± 1.5 to 7.5 ± 2.3 mmol/L89 [± 27 and 136 ± 40 mg/dL]. Fasting-related side effects were all temporary, and slightly more prevalent in those with type 1 diabetes. Mean daily insulin dose was adjusted from 24.4 (3-50) IU on the day before fasting to 7.6 (0-26.7) IU on day 7. Quality of life (WHO-5) normalized from 54.0 ± 4.4 to 68.8 ± 15.0 (p = 0.01) after fasting. The was a decrease from before until the follow -up four month late of weight from 77.6 ± 20.4 kg to 76.6 ± 20.9 kg (p = 0.023) and for the BMI from (27.68 ± 7.04) to (26.74 ± 7.15) kg/m2 (p = 0.008). Diastolic blood pressure increased from 69.75 ± 11.41 mmHg to 75.74 ± 8.42 mmHg (p = 0.028) and stayed in a healthy range on average.
Conclusions/Interpretation: This study demonstrates the feasibility, benefits and safety aspects of a 7-day fast in adults with type 1 diabetes.
I fasted 2 weeks ago for 5 days and from day 3 on without insulin. I am a Typ 1 diabetic for 24 years now. It is a great feeling to live without insulin. Even if it's only for a couple of days...
Dear Marina, thanks for your comment! We usually do not recommend to stop insulin substitution completely, because this might cause the risk of even higher need of insulin later. Only in LADA diabetes it might be possible without risk, because self-regulation still is better in LADA diabetes. But we do not have enough data to show this and urgently need more research. Bettina
Bettina
replied on 02 September, 2020
Dear Marina, thanks for your comment! We usually do not recommend to stop insulin substitution completely, because this might cause the risk of even higher need of insulin later. Only in LADA diabetes it might be possible without risk, because self-regulation still is better in LADA diabetes. But we do not have enough data to show this and urgently need more research. Bettina