Seven-day fasting as a multimodal complex intervention for adults with type 1 diabetes: Feasibility, benefit and safety in a controlled pilot study

Seven-day fasting as a multimodal complex intervention for adults with type 1 diabetes: Feasibility, benefit and safety in a controlled pilot study(FaMeD1)
Abkürzung	FaMeD1
Status	Abgeschlossen
Publikation(en)
Website	https://www.uni-wh.de/gkls/forschung/projekte/integrative-typ-1-diabetologie/

Seven-day fasting as a multimodal complex intervention for adults with type 1 diabetes: Feasibility, benefit and safety in a controlled pilot study. Diese Studie untersucht die Möglichkeit des Fastens bei Typ-1 Diabetes. Federführend war Bettina Berger. Die Studie gewann den Holzschuh-Preis 2021.

Abstract

Objectives

Intermittent as well as prolonged fasting are receiving considerable attention and appear favorable in conditions such as metabolic syndrome, type 2 diabetes, and rheumatic diseases. Fasting for individuals with type 1 diabetes (T1D) is generally considered too risky. However, the ability and possibility to change from carbohydrate- to ketone-based fuel supply might be relevant for individuals with T1D. The aim of this patient-led research was to investigate the feasibility, benefit, and safety of a 7-d multimodal fasting intervention in individuals with T1D.

Methods

This was a non-randomized controlled pilot study, with 20 participants with T1D and 10 without the disease. Data acquisition took place before, after, and 4 mo after the intervention and daily during intervention.

Results

Of the individuals with T1D, 19 finished fasting. A mean β-hydroxybutyrate as representative ketone body increased to 2.8 ± 1.9 mmol/L on day 7; whereas average glucose remained between 4.9 (±1.5) and 7.5 (±2.3) mmol/L (89 ± 27 and 136 ± 40 mg/dL). Mean daily insulin dose was adjusted from 24.4 (3–50) IU on the day before fasting to 7.6 (0–26.7) IU on day 7. Quality of life (WHO-5) normalized from 54 (±4.4) to 68.8 (±15; P = 0.01) after fasting. There was a decrease from before until the follow-up 4 mo later of weight from 77.6 (±20.4) to 76.6 (±20.9) kg (P = 0.023) and for body mass index from 27.68 (±7.04) to 26.74 (±7.15) kg/m² (P = 0.008). Diastolic blood pressure increased from 69.75 (±11.41) to 75.74 (±8.42) mm Hg (P = 0.028) and stayed in a healthy range on average. Fasting-related side effects were all temporary, and slightly more prevalent in those with type 1 diabetes compared with the reference group.

Conclusions

This study demonstrated the feasibility, benefits, and safety aspects of a 7-d fast in adults with T1D.

Weblinks

• Video: Präsentation der Machbarkeitsstudie (für den ECIM 2021/in englischer Sprache) - https://www.hufelandgesellschaft.de/fileadmin/Videos/Berger-ECIM2021%20.mp4
• Video: Präsentation der Machbarkeitsstudie (für die Preisverleihung/in deutscher Sprache) - https://www.hufelandgesellschaft.de/fileadmin/Videos/Berger%20et%20al_FastenBeiDiabetesTyp1.mp4

Publikationen

• Studienprotokoll: Bettina Berger, Rainer Stange, Andrea Baumann, Diana Köblös, Daniela Liebscher, Martina Bley, Andreas Michalsen, David Martin: Fasten für Menschen mit Typ-1-Diabetes (FaMeD1). In: Ernährung & Medizin. 34, Nr. 02, 17. Juni 2019, ISSN 1439-1635, S. 74–81. doi:10.1055/a-0831-6231.
• Bettina Berger et al: Seven-day fasting as a multimodal complex intervention for adults with type 1 diabetes: Feasibility, benefit and safety in a controlled pilot study. In: Nutrition. Band 86, 2021, doi:10.1016/j.nut.2021.111169.