Fasting with type two diabetes

Ryan Paul discusses fasting in patients with type 2 diabetes. He focusses on planned fasts, rather than illness, including the benefits and dangers of fasting.

Topics

Intro
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Fasting in T2D
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Potential benefits
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Any potential risks?
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Medications during fasting
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Dietitian involvement
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Do you recommend fasting?
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Trial data to support fasting?
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Direct trial findings
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Advice and patient approached
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Take-home messages
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Take home messages

Various types of intermittent fasting are becoming popular for weight loss and ‘reversing’ type 2 diabetes.
Intermittent fasting is associated with short-term improvements in weight, glycaemic control and cardiovascular risk, but there is a lack of conclusive long-term benefits.
Intermittent fasting may be associated with an increased risk of hypoglycaemia, diabetic ketoacidosis, gout, hypotension and malnutrition in certain groups
Alteration of glucose lowering therapies and other medications may be required to keep patients safe whilst fasting
Other dietary interventions are likely more effective in achieving long-term improvements in glycaemic control, weight loss and cardiovascular risk

Resources

Patient Resources

Presenter

Ryan Paul

Endocrinologist

Ryan is a Diabetologist at the Waikato District Health Board and a Senior Lecturer at the University of Waikato. Particular research interests include the use of emerging technologies in type 1 diabetes, the management of diabetes in youth and young adults, reducing inequities in diabetes care in Māori and rural populations, and improving models of diabetes care. Ryan has just stepped down as the President of the New Zealand Society of Endocrinology (NZSE) and is an Executive Member of the New Zealand Society for the Study of Diabetes (NZSSD). Ryan is a Clinical Associate of the Maurice Wilkins Centre and was awarded the New Zealand Clinical Educator of the Year by the New Zealand Medical Council in 2019.