Clinical potential of fasting in type 1 diabetes

• Published in: Trends in endocrinology and metabolism 2024-05, Vol.35 (5), p.413-424
• Main Authors: Varady, Krista A., Runchey, Mary-Claire, Reutrakul, Sirimon, Vidmar, Alaina P., Chow, Lisa S.
• Format: Article
• Language: English
• Subjects: Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - therapy; Fasting - physiology; glycemic control; Humans; intermittent fasting; obesity; Obesity - diet therapy; Obesity - metabolism; safety; time-restricted eating; type 1 diabetes
• ISSN: 1043-2760; 1879-3061; 1879-3061
• DOI: 10.1016/j.tem.2024.01.007

Intermittent fasting may serve as a safe and effective dietary intervention to reduce body weight and improve glycemic control in patients with obesity and type 1 diabetes (T1DM).Although clinical trial findings are still very limited, evidence suggests that individuals with T1DM may safely undertake intermittent fasting with a limited risk of diabetic ketoacidosis or severe glycemic disturbances.Findings also show that intermittent fasting may help patients with T1DM lower body weight and hemoglobin A1c, although findings are variable.For patients with T1DM wishing to start a fasting program, it is imperative that these individuals be in frequent contact with their healthcare providers, particularly in the early stages of diet.It is also recommended that these patients use continuous glucose monitors (CGM) daily to closely monitor their glucose levels during the fast. The real-time CGM data can help patients make informed decisions about their fasting programs and adjust their approach according to how their glucose levels respond to this diet therapy. Most adults with type 1 diabetes (T1DM) are either overweight or obese. As such, dietary management is recommended as an adjunct to insulin treatment to improve glycemic control and facilitate weight loss in these patients. Time-restricted eating (TRE) is a form of intermittent fasting that offers a simplified approach to treating obesity in T1DM. TRE typically involves restricting eating to 6 to 10 h per day, with water and medications allowed outside the eating window. This review examines the efficacy of TRE and other fasting protocols in improving weight and glycemic control in patients with obesity and T1DM. This review will also evaluate the safety of these regimens and provide advice to clinicians on implementing intermittent fasting in T1DM. Most adults with type 1 diabetes (T1DM) are either overweight or obese. As such, dietary management is recommended as an adjunct to insulin treatment to improve glycemic control and facilitate weight loss in these patients. Time-restricted eating (TRE) is a form of intermittent fasting that offers a simplified approach to treating obesity in T1DM. TRE typically involves restricting eating to 6 to 10 h per day, with water and medications allowed outside the eating window. This review examines the efficacy of TRE and other fasting protocols in improving weight and glycemic control in patients with obesity and T1DM. This review will also evaluate the safety of thes