To fast or not to fast, that is the question. This is actually a pretty big question and to do it justice we'd need a lot more room than I have here, so this is definitely something that I'll be writing more on in the future. For now though I want to touch on a few things that will get us thinking about this more.
Dr. Jason Fung has had quite a bit of success using intermittent fasting, and that's the kind of fasting that we're talking about, and I do think quite a bit about his work generally, and the part about looking to reduce insulin is one that I definitely agree on. When I first watched one of his videos, it was like, wow this guy really gets it, and he's an MD too, amazing!
So the benefit of intermittent fasting to diabetes, and to obesity and metabolic disorder as well, is to limit the area under the curve for insulin levels. This really comes down to how we're going to time our meals, and the debate is between whether we should eat less often but bigger meals or smaller meals more often.
Dr. Fung points out, correctly, that eating less often, and in particular, using intermittent fasting, will reduce insulin levels. Now this is something we want to do with diabetics as well, even though a lot of people, most people, actually just about everyone thinks type 2 diabetics should be increasing their insulin levels, not decreasing them.
It's pretty clear that a lower carb diet, carb restriction to some extent in other words, does help diabetes, and especially in managing the disease long term, slowing down or even halting its progression. Now the reason for this isn't so much its beneficial effects on day to day blood sugar levels, although it does tend to help with that, it's actually to a large extent because on a diet like this we secrete less insulin.
Things that increase insulin levels increase insulin resistance and therefore worsen diabetes, and things that lower insulin levels improve insulin resistance, which is what we want, because too high insulin levels is the killer here when it comes to insulin resistance.
Now there's more to a low carb diet than just this but this is one of the big things it does, reducing insulin levels.
Now what if we took this one step further and did intermittent fasting to reduce insulin levels even further? Well it's a good idea in theory anyway, but like all things, it's a lot less simple than it appears.
We know that there are issues with low carb and certain hormones, this diet does mess up things like adrenal function, thyroid function, and sex horomone function, to various degrees, although these degrees to seem to differ quite a bit among different patients. Sometimes these effects may be present but they may lessen over time, although this is going to depend on the individual and we must be aware of at least the potential of these effects, rather than just saying, well cut all the carbs you want, you will be fine.
Intermittent fasting does the same thing, and in particular it elevates cortisol, which when too high is a big enemy of blood sugar. It also has effects on thyroid hormone function, and for the same reasons as low carb does actually, this creates metabolic changes that are conservational in nature, which may serve a purpose but maintaining good blood sugar isn't one of them.
In fact, it may be that persistent high blood sugar may be conservational as well, in other words, our bodies are acting as if there is a lack of sorts, and is taking measures to better equip ourselves to deal with such things, including maintaining a higher than normal blood sugar level.
In any case, there are plusses and minuses when it comes to how often a diabetic should eat, and like a lot of things, it's not as easy as we may like perhaps to be able to properly judge which path is best. It's certainly not just a matter of measuring short term blood sugar levels as there may be changes that are influencing results that take quite a bit of time to manifest fully, so we may have to hang with something longer term to get a good idea of the overall effect.
We can theorize away though all we want but ultimately it does come down to the results, and we differ too much to really say too much about all of this other than give them both a try and see what happens, to you..