'Type 2 diabetes is a dietary problem'

It's Navratri. People are fasting. Intermittent fasting (IF) is gaining acceptance in the medical community. What is IF? It's a self-imposed time window on how many hours we fast versus feast. Last week, the esteemed British Medical Journal published the headline "Myth exploded" featuring a case report on IF as an insulin alternative in Type 2 diabetes. Since June, I have been medically supervising IF for Type 2 diabetes.

Although this form of diabetes has been typically considered a problem of too much blood sugar, it actually starts much before that as a problem of too much insulin. What kind of lifestyle causes too much insulin? One that is high in carbohydrates, sedentary, stressful and deprived of good sleep.

Conventionally, Type 2 diabetes is "treated" with one, then two, then three, even four drugs and then insulin injections while the patient continues the same carbohydrate rich, low fat diet, eating 6-7 small meals a day. They are told to keep eating to prevent a low blood sugar level (a side-effect of the prescription drugs and not a side effect of Type 2 diabetes). Each time they eat, they get an insulin response and can't lose weight. We just can't reverse type 2 diabetes this way.

Always discuss with your doctor if you want to fast. They may need to adjust your medication. Fasts allowing potato, sabudana, milkshakes, sama, sooji and fruits all raise insulin levels. That's very different from medical IF which reduces insulin levels by allowing for fluids that don't raise insulin, such as salted lime water, green tea, black coffee, vegetable broth and non-caffeinated teas.

How can we use medical IF in diabetes? A fasting C-peptide blood test will indicate if your pancreas is still making its own insulin. Some diabetes drugs are safe during fasting and some aren't. Co-ordinate with your doctor who can adjust the medication, allowing you to reduce your carbohydrate intake and fast safely. This is how medical IF lowers insulin levels and reverses Type 2 diabetes.

What you eat on non-fasting days is a matter of choice but fasting is more effective as a treatment for Type 2 diabetes on a background nutrition plan of low carbohydrates, healthy fat and sufficient protein.

When the doctor thinks it's safe, s/he can start you on 16 hours of fasting twice a week, gradually increasing up the hours of fasting while reducing the medications that cause low blood sugar. Monitor blood glucose levels on your meter frequently and stay in close contact with your doctor on your initial symptoms that can occur while getting used to fasting.

The writer is an American Board Certified Consulting Endocrinologist, who runs the Khar-based Aasaan Health Solutions, LLP

Catch up on all the latest Mumbai news, crime news, current affairs, and also a complete guide on Mumbai from food to things to do and events across the city here. Also download the new mid-day Android and iOS apps to get latest updates