The effectiveness of fasting in combating insulin resistance among type 2 diabetic individuals
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Abstract
For over 50 years, Americans were led to believe that diets high in carbohydrates but low in dietary fat was healthy and normal. Now, over 34 million Americans are diagnosed with diabetes, 95% of that population having Type 2 Diabetes Mellitus (T2DM). Insulin resistance is a known marker for pre-diabetes and other health related issues. An individual can develop insulin resistance by chronic intake of high carbohydrate and high fat foods. Researchers are constantly finding methods to improve an individual’s insulin sensitivity and hopefully cure T2DM. There is now a general agreement amongst the literature that a diet lower in refined carbohydrates together with exercise can aid in the prevention of insulin resistance and therefore T2DM. A newer, more drastic method that is still being researched and evaluated is known as fasting. Various forms of fasting exist such as intermittent fasting, alternate day fasting (ADF), brief fasting (BF), and prolonged fasting (PF). Fasting itself is not new and has had religious roots in Catholicism and Islam.
Across the current literature, studies have suggested that fasting results in marked weight loss, and in some cases, fat mass loss. It should be noted that some cases report no significant difference in weight loss between caloric restriction and fasting. Fasting may have other health benefits that could be advantageous to an individual over solely caloric restriction. Many cases also claim improvement in insulin sensitivity, decreased insulin resistance, as well as positive changes to blood pressure, glucose levels and cholesterol levels. A few studies reported other benefits such as decreased appetite, increased cognition, autophagy, and reduced inflammation. Individuals who suffer from insulin resistance and T2DM may also suffer from hypertension, obesity, high cholesterol, and other negative health issues. Compared to caloric restriction, patients may find it beneficial to practice fasting alongside caloric restriction and exercise to improve insulin sensitivity.
Given the current literature, negative health issues or side effects associated with fasting have not been reported. The biggest issue amongst trials was adherence of the fasting practice. One study had noted after a one-year follow up; subjects regained most of their lost weight. Further research, specifically long term randomized controlled trials on human subjects, is needed to reach a more significant conclusion. The longest study was one year in duration. Some studies also have used mice as subjects but not all theories have been tested on humans. Because of to the lack of long-term trials, certain health benefits or negative health issues associated with fasting are still unknown.