Diabetes: Cure Through Fasting?

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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Intermittent Fasting! Juice fasting! Base fasting! The good old therapeutic fasting has come in many different facets for a few years - and is suddenly quite trendy. Some hope to lose weight with it, others want to learn to enjoy more consciously again. For many, however, the health aspect is in the foreground. In fact, more and more studies confirm that fasting not only keeps you healthy, but can also make you healthy.

One example of this is type 2 diabetes. "Even if you don't eat for 16 hours, your sugar metabolism improves," says Prof. Stephan Herzig from the Helmholtz Diabetes Center Neuherberg in an interview with

It is not only the current blood sugar levels that benefit from this: "It is much more exciting: the sugar absorption and processing in the body is also improved," says the diabetologist. It is precisely these processes that are disturbed in people with type 2 diabetes. And fasting, it is hoped, could reverse that.

Body cells react poorly to insulin

Diabetes develops slowly. It starts with the body cells responding less and less to the hormone insulin. In this case, doctors speak of reduced insulin sensitivity or insulin resistance.

Insulin has the job of a gatekeeper: it channels sugar from the blood into the cells for further use. If this only works to a limited extent, the body increases insulin production in order to keep the blood sugar level under control. The affected person goes unnoticed into a state of so-called prediabetes: the sugar metabolism is already affected, but you still don't feel any of it.

Sugar metabolism recovers during fasting

“After a fast, the hormones can work better again. Sugar intake and processing benefit from this, ”says Herzig. Fasting can therefore prevent diabetes in advance - this has been known for a long time. Risk candidates in particular can pursue this strategy. This includes people who are overweight and close relatives of people with diabetes.

But does fasting also help if the child has fallen into the well, i.e. type 2 diabetes has already manifested itself? In fact, various studies now suggest that just that might be possible.

Does diabetes start in the liver?

The liver apparently plays a central role in this. It not only serves to detoxify the blood, it is also a kind of transit store for energy in the form of sugar and fat. This is useful because it can quickly provide the body with energy when needed. However, if there is a constant oversupply of nutrients, the liver stores too much fat: "80 percent of all overweight people have fatty liver," says Herzig. In the long term, the liver tissue rebuilds and scars: cirrhosis of the liver develops.

Fatty liver, however, promotes diabetes and could even play a key role in the disease process. Some researchers speculate that the organ defends itself against obesity by reducing its insulin sensitivity. "But if the liver no longer reacts to insulin, it also has an impact on the overall metabolism," confirms Herzig. Mechanisms could then take place that mutually reinforce one another.

Fasting against fatty liver

The most effective remedy for fatty liver? Again is fasting! Because the liver responds particularly well to such a hunger regime. "If you manage to break down liver fat, the cells react more sensitively to insulin again - in the entire organism," says Herzig.

For diabetics, this can specifically mean that they need less sugar-lowering medication after a fast, or that type 2 diabetics who need insulin can get away from the syringe again. In some patients, the blood sugar balance normalizes to such an extent that they no longer need any medication at all.

So are these diabetics cured? “The effects observed after fasting can be attributed to improved insulin sensitivity. The question is whether one can speak of a real remission, ”says Herzig. What is meant by this is that the cause of the disease has really been turned back. “There is more to that,” says the diabetologist.

The pancreas is exhausted

Because the insulin resistance of the body cells is only one of the reasons why the blood sugar levels rise in type 2 diabetics. In the course of the disease, the insulin-supplying beta cells in the pancreas also become limp because they constantly have to fight against insulin resistance. At this point at the latest, the body can no longer shovel the glut of sugar out of the blood: The blood sugar rises higher and higher. “Only when that happens do we have real type 2 diabetes,” says Herzig.

Reboot for the beta cells

Initial studies on mice suggest that beta cells that have died through fasting can actually be revived. "This theory is now in the room," says Herzig.

For example, researchers around Dr. Christian Baumeier from the German Institute for Nutritional Research, diabetes mice on an extremely low-calorie diet that imitates fasting for four days in a row. Sugar and proteins were almost completely eliminated, only short-chain fatty acids were fed. Afterwards, beta cells in the pancreas of the animals actually began to produce insulin again and the rodents' blood sugar levels fell.

The researchers suspect that the beta cells were reprogrammed by the hunger regime and returned to their functional basic state. But it is also possible that completely new cells have formed.

Critics of the widely acclaimed study doubt, however, that the results can be transferred to humans. Herzig is cautiously optimistic: "That would be a real remission," says the diabetologist.

Fasting works at every stage of the disease

Normal blood sugar levels through fasting? The chances of this are particularly good for diabetics, whose disease has only existed for a comparatively short time. Changes in lifestyle generally work better for them than for long-term patients. An intensive sports program or significant weight loss can also have the greatest effect on “fresh diabetics”. Experts therefore recommend taking massive action against the disease after the diagnosis.

But long-term diabetics also benefit from fasting programs. In a small case study, researchers led by Dr. Suleiman Furmli from the University of Toronto, for example, tried to make three patients who had suffered from diabetes for 10 to 25 years independent of artificial insulin with daily intermittent fasting.

Herzig's colleagues at the Helmholz Center are researching how fasting can affect the long-term effects of diabetes. For example, the high sugar levels damage the kidneys in the long term. "So far, there is no effective therapy against such nephropathies," explains the diabetologist. The Helmholz researchers found that the organs partially recovered through fasting.

No fasting on your own!

Fasting definitely seems to pay off for diabetics. Whether classic Buchinger fasting for one or more weeks, intermittent fasting with meal breaks between 16 and 36 hours or a fasting-imitating diet - there are studies for all forms that prove that they have a beneficial effect on diabetes.

However, diabetics should not go through a fast on their own. Herzig urgently advises you to work closely with your doctor. In particular, if the patient injects insulin, the dosage must be adjusted. “You have to be careful not to slip into hypoglycaemia. Otherwise it can be dangerous, ”warns Herzig. Frequent blood sugar measurements are therefore compulsory when fasting.

Which fasting method is best?

Which form of fasting is most effective is still open - but also of secondary importance: "You have to come up with a scheme that you can hold out for a long time," says Herzig. Fasting a full day twice a week is quite a lot. “If you can keep it up for just a week or two, it won't do much.” Probably the easiest thing for most people is to skip one meal a day, for example breakfast. "Then you can live and eat normally for the rest of the day."

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