While the trail ambled up and up Icicle Ridge, flashing the tart reds and sunny golds of autumn maple and willow, my girlfriends rambled on and on about something called “I.F.” I finally had to interrupt.
“What’s I.F.?”
“Intermittent Fasting. It’s wonderful. I thought my ‘spare tire’ was here to stay. But I.F. melted it away.”
“Right?” the other chimed in. “At first I was scared of I.F., afraid I’d feel ‘hangry.’ But now that my body’s used to it, I.F. makes me feel cleansed and sharp, focused.”
Huh. Really.
Fasting. I flinch just thinking about it. ‘Fasting’ has always been one of my least favorite words. For years I was, unknowingly, a sugar addict: back then fasting turned me ravenous, shaky, jangled, and brain-dead.
This inexplicable enthusiasm by my friends for what seemed a clearly horrible concept started me on a journey. I would discover that my fasting-fear reflex was my old addiction talking, not my recovered body’s response—not the ‘normal’ response to a pause between meals.
I began to poke around in the science of Intermittent Fasting (I.F.). Research kept pointing toward growth hormone.
Growth hormone helps kids grow; and remains important our whole lives. In adults it helps us build lean tissue and burn fat. Growth hormone is typically released as we sleep, and I.F. can lengthen the release period of growth hormone.
Frustratingly,people use the term I.F. to mean different things. Some people mean minimizing snacking, and spacing meals at least four hours apart. For diabetics of all types, this is a great idea. With four hours between meals, we rest our gut, avoid insulin ‘stacking,’ and start a meal’s effect on our blood sugar (BG, blood glucose) from a mellow low instead of choppy high seas. All this makes it easier to keep our BG within a safe zone.
Spacing meals by at least four hours is the most wide-spread advice doctors give to all types of diabetics.
Sometimes when people say I.F. they mean extending the overnight break from eating. These folks may wait to eat for several hours after waking, or stop eating several hours before bedtime. Many find that this long overnight gut-rest helps them reduce overall calories, and gets hormone patterns, especially growth hormone, working toward weight loss.
Still others mean even longer I.F.’s, such as not-eating one day in three, or one day a week.
In an insulin-normal person, all of these types of I.F. seems to be a mildly good idea—super-helpful to some, not helpful to others, and everywhere in between. I.F. can help insulin-normal people who wish to lose weight, especially those above middle age.
T2 diabetics typically respond to I.F. much like an insulin-normal person. I.F. can be helpful for a T2 who is trying to lose or manage weight.
For T1 diabetics, low BG is an overriding concern, so fasting can be problematic. Thanks to CGMs and pumps, T1s no longer need to be as rigid about meal schedules as in the old days. Still, many T1s find that a predictable, well-spaced meal pattern fitted to their personal work and play schedule makes it easier to anticipate insulin needs and to consciously ‘be their own pancreas.’
For LADAs… it’s complicated.
If I.F. means four hours between meals: great, yes, two thumbs up.
If I.F. means stretching the overnight fast: this could be good or bad depends on how many beta cells we have left. The less insulin we are able to produce, the more likely that too long a fast will provoke our liver into emergency mode, and cause the liver to dump sugar into our blood which we won’t have the insulin to balance.
LADAs are the most diverse group of diabetics. We stretch along a broad continuum depending on how much insulin we produce and how much, if any, insulin resistance we may have.
Some LADAs find that giving the gut a nice long rest overnight—delaying breakfast or eliminating the bedtime snack—helps BG control. Others find that too long an overnight span without food sends the liver into a sugar frenzy, and these folks may find a bedtime snack high in fat or protein helpful. As LADA progresses, we may eventually require basal insulin to get through even a normal 8-hr night without blood sugar spikes and crashes.
This is precisely why we test our BG—not to generate some scolding report card but because testing is the only way to answer highly-personal questions—like this one—which no one else can answer for us.
Personally, I tend to wait a few hours in the morning before breakfasting. And also, for me, going too long between meals can spike my BG higher than eating does. The liver doesn’t mess around when it thinks we’re starving!
Bottom line: For all diabetics: space your meals four hours apart whenever practical. For LADAs, longer fasts may help or hurt, depending on exactly where on the continuum you are at this point in time.
Access your diabetic superpower: test-test-test how different types of I.F. affect your BG.
Use test-test-test to discover your whole BG picture, then talk to your doc.
