Diabetic and former Diabetes genetic researcher here.
To paraphrase an old mentor, curing diabetes in mice is kind of the sport of the field. It's been done a number of times. Mice have some abilities to regrow tissue we don't. It's unclear how well various mouse models for diabetes mimic the human phenotypes.
I am very hopefully for this line of research in general but I expect any cure in humans will be more complex and perhaps also deal with somehow suppressing the immune response that destroys the Beta cells in type 1's like myself. For a type 1 the best I'd expect something like this to be able to achieve is a temporary return to the "honeymoon" period where the pancreas still produces enough insulin to make small adjustments but supplemental insulin is required.
On a personal level i have found that diet can have massive effects on my diabetes management. I may try a diet like this (with the advice of a doctor in adjusting insulin to handle it well etc and with the realization i may need to break the diet to treat low blood sugars etc). Edit: I also use a continuous glucose monitor which helps greatly with avoiding low bloodsugars while changing diet/activity levels and recommend one to any other diabetics.
For what it's worth, I'm a T1D that has been in honeymoon for three years since diagnosis (with no external insulin) by going on a ketogenic diet. (Disclaimer - no one try this without consulting your endocrinologist...)
"Diabetic and former Diabetes genetic researcher here."
Thank you for commenting here. As you are a diabetic who was also a diabetes researcher, I think it would be helpful to have you describe your exercise regimens (both cardio and resistance training) as well as your own experience with fasting and/or intermittent fasting ?
Since this is now one of the top comments, I should have been clearer. If I try something like this I'll do so as part of the proud tradition of self experimentation with a hearty skepticism of it actually producing any lasting effect.
I have gone through this thread and given a downvote to every post that's giving dangerously-incorrect medical advice. Which seems to be most of them.
I don't expect anyone who's actually diabetic to fall for this; every T1 diabetic is in practice forced to become an expert. But, for the sake of confused bystanders: for a diabetic using insulin, fasting is dangerous. That's not an abundance of caution thing; we diabetics micromanage a key part of our metabolism using insulin, and if we leave the range of metabolic states we're familiar with we'll get insulin dosages wrong. The most likely outcome of trying to fast for a day would be being forced to abort the fast by hypoglycemia.
As a person with type 1 diabetes I would like to add that, just as one has to learn what amounts of insulin to inject when one first starts using insulin with his/her given diet, one would need to learn what amounts of insulin are appropriate for the days one is on this diet.
And if you had to abort the fast a few times before you home in on your insulin needs during the fast, that is not a life or death situation.
I feel you are being too cautious. Please chime in if you feel I'm being cavalier. Thanks!
It is worth noting that while there is evidence that murine beta cells can regenerate even late into life, there is very little indication that human beta cells can do the same. Many beta cell regeneration studies die in between mouse and human studies. Some more on the questions around regeneration here: http://diabetes.diabetesjournals.org/content/59/10/2340 with discussion of human versus rodent toward the end.
I don't understand why it's potentially so dangerous to try it out on your own. Fasting is kinda natural. Assuming you go back to the roots and live in the forest. You are not going to eat every day... so why is it suddenly so dangerous?
Some explanation on the risks would have been helpful.
I understand health advice sometimes has obnoxiously overcautious disclaimers, but the warning seems valid in this case. It's referring to people who already have a serious condition - diabetes - reminding them not to suddenly make a major intervention in their eating routine.
I agree. I've been water-only fasting five consecutive days every two weeks for over a year now (largely but not entirely as a result of Longo's work).
I assume that telling people they need medical guidance before doing so is a means of avoiding liability should someone do something stupid.
The only plausible risk I've seen mentioned, by Longo himself, is in women where the risk of gallstones might be increased. To quote him "Water-only fasting should only be done in a specialized clinic. Also, certain types of very low calorie diets, and particularly those with high protein content, can increase the incidence of gallstones in women at risk." [0]
The idea that water-only fasting should only be done "in a specialized clinic" seems daft to me, but in a litigious society I can understand why he says that.
Other researchers worth following in this area are Mark Mattson and Luigi Fontana.
"Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes)." (emphases mine)
I did this diet by myself a couple of years back and had great results (slightly modified, I did 1200 calories a day with a daily jog - works out at a net of roughly 800 calories). I found the first 4 days pretty uncomfortable but after that the diet was easy to follow. After a few days I was able to stop taking medication completely and ever since have been able to just use diet/exercise. I now do a top-up week about once every 6 months or so which I find is necessary to maintain the same level of glucose control (HBA1C is now 5.6, down from 8.1 at diagnosis).
I agree that fasting seems natural and as a doctor (though not an endocrinologist) I can tell you that it is generally safe for most people with what I would call "normal" physiology.
However, the discussion here is not about people with "normal" human physiology.
Remember what diabetes is: simplistically, it's the inability to properly regulate the glucose in the blood vs in the cells. Type I diabetes is an autoimmune condition that results in the destruction of the insulin-producing cells of the pancreas. Without insulin, blood glucose levels elevate but the cells of the body continue to starve.
Type I diabetics are basically trying to synthetically replace the activity that their pancreas would be performing through a combination of carefully regimented eating (including very close attention paid to carbohydrate) and blood glucose checks / insulin injections. Suddenly changing over to a fasting diet without careful supervision from a physician could be lethal for a type I diabetic.
We live in a pretty litigious society. Everything has to be caveated to cover the lowest common denominator. On top of that nutrition is a complex subject filled with a lot of mis-information. In this particular case fasting can be risky for those who are obese or have a lot of toxins in their fatty tissue.
From what I understand, pollutants in food (from pesticides and other sources) and in the environment which are not easily broken down are stored by the body in fat.
Fasting or sudden weight loss can cause these toxins to be released more rapidly than would otherwise be the case. This can tax your system pretty heavily if you're obese or have a higher incidence of pollutants in your body.
I know it shouldn't be a big deal to fast even for a few days, and I don't find hunger to be a problem, but I do find feeling very drunk-dizzy and incredibly tired starting around hours 14-16 to be a problem. That part definitely doesn't feel very healthy, and it's what's keeping me from making 1day+ long fasts part of my regular routine.
I'd like to give another perspective. When someone says people should not start exercising before seeing a doctor and without supervision, they are saying: you can die!
And people can really die if they "go back to the roots" and start running pursuing animals.
So, when someone says: don't this radical change in your nutrition habits, people should listen carefully.
Because for diabetics your diet and changes to can lead to wild swings of your glucose levels and would require much more diligent monitoring, something individually is very hard to do while asleep. Sleeping is not a good time to have a low sugar even and it can happen quickly and you just don't wake up from it.
purely anecdotal but my mother has seen high levels before going to bed only to wake up dangerous low. Or the fun good level and suddenly in the morning you are at 300+. Ask three doctors at hospital and get three different opinions.
No, don't do it at home and don't do it unless monitored by a health care professional who knows how to respond.
The research has been going on for a decade about metabolic.
I use to fast once a week from dinner to dinner (Prior to midnight day break most of the world's day started at sunset so a day fast was from sunset to sunset). I seriously need to jump back on the fasting bandwagon my self-discipline has gotten lower and lower ever since I hit my mid-thirties and got married.
AFAIK, type 1 diabetes is thought to be an autoimmune disease, where the immune system incorrectly identifies the beta cells as an infection/foreign body and destroys them.
With that in mind, I wonder how effective this actually is. I (I'm a T1 diabetic) grow some new beta cells, my overly aggressive immune system wipes them out again..
EDIT: reading the reddit thread (https://www.reddit.com/r/science/comments/5vufpb/the_pancrea... - thanks austinjp) i'm not the only one to ask this. The general consensus is it's not going to be useful for T1 diabetics, it's just treating the symptoms, not the cause (the immune system), again (like injecting insulin).
A friend of mine was on the brink of Type 2 diabetes and reversed the symptoms / indicators after reading about the Newcastle University study. Worked for him.
I had metabolic syndrome x, pretty much the final stage before type 2 diabetes.
I also had an undiagnosed (despite every test the docs could think off).
I went on a 1500 calorie a day diet for 7 months and dropped weight from 245lbs to 185lbs (I'm 6 foot) at the next doc appointment indicators where all in normal range and at the most recent they where all excellent for someone my age.
Diet for this 7 months was cottage cheese, veg, nuts and rolled oat porridge with either chicken or fish and veg.
No fruit, lots of supplements and a protein shake before bed.
First month was grim I felt terrible all the time but every month after was easier.
"The human version of the FMD is a propriety formulation belonging to L-Nutra (http://l-nutra.com/prolon/). It is a plant-based diet designed to attain fasting-like effects on the serum levels of IGF-I, IGFBP1, glucose and ketone bodies while providing both macro- and micronutrients to minimize the burden of fasting and adverse effects (Brandhorst et al., 2015). Day 1 of the FMD supplies ∼4600 kJ (11% protein, 46% fat, 43% carbohydrate), whereas days 2-5 provide ∼3000 kJ (9% protein, 44% fat, 47% carbohydrate) per day. The FMD comprises proprietary formulations of vegetable-based soups, energy bars, energy drinks, chip snacks, tea, and a supplement providing high levels of minerals, vitamins and essential fatty acids (Figure S3). All items to be consumed per day were individually boxed to allow the subjects to choose when to eat while avoiding accidentally consuming components of the following day. For the human subjects, a suggested FMD meal plan was provided that distributes the study foods to be consumed as breakfast, lunch, snacks, and dinner. (See lists below for ingredients and supplements)"
Type 1 diabetic here, I'm sure if you still retain a small amount of basal insulin in combination with regular glucose monitoring I can't see how it would be dangerous? The real danger would be the billion dollar insulin business looking to discredit this research.
How to read this thread: "what's right _for me_" not "what's right".
Also, it's impractical to fast when you have work to do and meetings. You risk becoming cranky and grumpy and pissing colleagues off. Better to fast when you have a day off or at night.
> He told the BBC: "It boils down to do not try this at home, this is so much more sophisticated than people realise." He said people could "get into trouble" with their health if it was done without medical guidance.
If T1D is properly managed (frequent testing, insulin injection every meal), fasting actually poses less danger than a typical diet that has carbs in every meal. Carbs set you up for a wild swing.
There was a headline yesterday on HN that most scientific results cannot be peer reviewed. Maybe this too falls in that category and we have to take it with a grain of salt.
Apparently I've been fasting daily pretty much most of my adult life. Last meal between 17-20, I generally never eat breakfast, and then eat lunch between 12-14. Maybe that explains why I'm rarely sick, and haven't been to a doctor since I was fourteen?
There are many form but the general thin is that cells get resistant to massive amounts of insulin, which are caused by high blood sugars, resulting in higher blood sugars and/or higher insulin levels which can cause damage to any tissue. As far as I know (I have T1 diabetes, no doctor though) the Beta cells producing insulin have (like any cells) a sort-of define lifetime/production level and stressing them out doesn't help you in the long run. You can take medication to allow cells to have easier access to insulin, be more susceptible to it or increase the betacell insulin production but these are generally stopgap measures which in the end result in nearing Type 1 insulin levels if no change in lifestyle is taken.
Many old people will get it (Type 2) anyway since the pancreas is simply out of juice, but with relatively simple medication it can be managed. Eating like a fat pig will definitely accelerate the reduction in betacell insulin production capacity and increase the insulin resistance of other cells as described above (nice feedback effect).
High blood sugar damages the pancreas beta cells. If you have poorly controlled high blood sugar for long enough, you will lose the ability to make insulin in addition to being insulin resistant.
[+] [-] micro_cam|9 years ago|reply
To paraphrase an old mentor, curing diabetes in mice is kind of the sport of the field. It's been done a number of times. Mice have some abilities to regrow tissue we don't. It's unclear how well various mouse models for diabetes mimic the human phenotypes.
I am very hopefully for this line of research in general but I expect any cure in humans will be more complex and perhaps also deal with somehow suppressing the immune response that destroys the Beta cells in type 1's like myself. For a type 1 the best I'd expect something like this to be able to achieve is a temporary return to the "honeymoon" period where the pancreas still produces enough insulin to make small adjustments but supplemental insulin is required.
On a personal level i have found that diet can have massive effects on my diabetes management. I may try a diet like this (with the advice of a doctor in adjusting insulin to handle it well etc and with the realization i may need to break the diet to treat low blood sugars etc). Edit: I also use a continuous glucose monitor which helps greatly with avoiding low bloodsugars while changing diet/activity levels and recommend one to any other diabetics.
[+] [-] ecesena|9 years ago|reply
[+] [-] cadr|9 years ago|reply
[+] [-] rsync|9 years ago|reply
Thank you for commenting here. As you are a diabetic who was also a diabetes researcher, I think it would be helpful to have you describe your exercise regimens (both cardio and resistance training) as well as your own experience with fasting and/or intermittent fasting ?
Thanks.
[+] [-] micro_cam|9 years ago|reply
[+] [-] agumonkey|9 years ago|reply
[+] [-] jimrandomh|9 years ago|reply
I don't expect anyone who's actually diabetic to fall for this; every T1 diabetic is in practice forced to become an expert. But, for the sake of confused bystanders: for a diabetic using insulin, fasting is dangerous. That's not an abundance of caution thing; we diabetics micromanage a key part of our metabolism using insulin, and if we leave the range of metabolic states we're familiar with we'll get insulin dosages wrong. The most likely outcome of trying to fast for a day would be being forced to abort the fast by hypoglycemia.
[+] [-] hockeybias|9 years ago|reply
And if you had to abort the fast a few times before you home in on your insulin needs during the fast, that is not a life or death situation.
I feel you are being too cautious. Please chime in if you feel I'm being cavalier. Thanks!
I too use a continuous glucose monitor.
[+] [-] karmel|9 years ago|reply
[+] [-] bresc|9 years ago|reply
[+] [-] mmahemoff|9 years ago|reply
[+] [-] sjcsjc|9 years ago|reply
I assume that telling people they need medical guidance before doing so is a means of avoiding liability should someone do something stupid.
The only plausible risk I've seen mentioned, by Longo himself, is in women where the risk of gallstones might be increased. To quote him "Water-only fasting should only be done in a specialized clinic. Also, certain types of very low calorie diets, and particularly those with high protein content, can increase the incidence of gallstones in women at risk." [0]
The idea that water-only fasting should only be done "in a specialized clinic" seems daft to me, but in a litigious society I can understand why he says that.
Other researchers worth following in this area are Mark Mattson and Luigi Fontana.
[0] https://news.usc.edu/82959/diet-that-mimics-fasting-appears-...
[+] [-] baldfat|9 years ago|reply
2) Some people's blood sugar really is an issue and they can't traditionally fast without serious low blood sugar
3) People's understanding of how people lived 100 years ago let alone 10,000 years ago is minimal
[+] [-] alex_duf|9 years ago|reply
Assuming you go back to the roots and live in the forest you're also a lot more likely to die.
[+] [-] edwhitesell|9 years ago|reply
This is right after they talk about using it as a treatment for diabetes. If you're already diabetic, doing this as a treatment could have some risks.
[+] [-] leereeves|9 years ago|reply
[+] [-] jlg23|9 years ago|reply
https://en.wikipedia.org/wiki/Diabetes_mellitus#Management
[+] [-] ollysb|9 years ago|reply
[+] [-] hanklazard|9 years ago|reply
However, the discussion here is not about people with "normal" human physiology.
Remember what diabetes is: simplistically, it's the inability to properly regulate the glucose in the blood vs in the cells. Type I diabetes is an autoimmune condition that results in the destruction of the insulin-producing cells of the pancreas. Without insulin, blood glucose levels elevate but the cells of the body continue to starve.
Type I diabetics are basically trying to synthetically replace the activity that their pancreas would be performing through a combination of carefully regimented eating (including very close attention paid to carbohydrate) and blood glucose checks / insulin injections. Suddenly changing over to a fasting diet without careful supervision from a physician could be lethal for a type I diabetic.
I hope that helps clarify.
[+] [-] leonroy|9 years ago|reply
From what I understand, pollutants in food (from pesticides and other sources) and in the environment which are not easily broken down are stored by the body in fat.
Fasting or sudden weight loss can cause these toxins to be released more rapidly than would otherwise be the case. This can tax your system pretty heavily if you're obese or have a higher incidence of pollutants in your body.
[+] [-] oskarth|9 years ago|reply
Disclaimer: Not a doctor.
[+] [-] ashark|9 years ago|reply
[+] [-] motoboi|9 years ago|reply
And people can really die if they "go back to the roots" and start running pursuing animals.
So, when someone says: don't this radical change in your nutrition habits, people should listen carefully.
[+] [-] eivarv|9 years ago|reply
[0]: https://en.wikipedia.org/wiki/Appeal_to_nature
[+] [-] Shivetya|9 years ago|reply
purely anecdotal but my mother has seen high levels before going to bed only to wake up dangerous low. Or the fun good level and suddenly in the morning you are at 300+. Ask three doctors at hospital and get three different opinions.
No, don't do it at home and don't do it unless monitored by a health care professional who knows how to respond.
[+] [-] hannob|9 years ago|reply
Today: Story about a weak, non-replicated animal study at the top of hacker news.
[+] [-] baldfat|9 years ago|reply
1) Decades old research on brain capacity and benefits of fasting http://www.johnshopkinshealthreview.com/issues/spring-summer...
2) Fasting increases chemotheraphy effectiveness in some chemos. https://www.scientificamerican.com/article/fasting-might-boo...
The research has been going on for a decade about metabolic.
I use to fast once a week from dinner to dinner (Prior to midnight day break most of the world's day started at sunset so a day fast was from sunset to sunset). I seriously need to jump back on the fasting bandwagon my self-discipline has gotten lower and lower ever since I hit my mid-thirties and got married.
[+] [-] austinjp|9 years ago|reply
http://reddit.com/r/science/comments/5vufpb/the_pancreas_can...
[+] [-] rb1|9 years ago|reply
With that in mind, I wonder how effective this actually is. I (I'm a T1 diabetic) grow some new beta cells, my overly aggressive immune system wipes them out again..
EDIT: reading the reddit thread (https://www.reddit.com/r/science/comments/5vufpb/the_pancrea... - thanks austinjp) i'm not the only one to ask this. The general consensus is it's not going to be useful for T1 diabetics, it's just treating the symptoms, not the cause (the immune system), again (like injecting insulin).
[+] [-] 6d6b73|9 years ago|reply
Prolonged Fasting Reduces IGF-1/PKAto Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression
https://drive.google.com/file/d/0B97CJJ5YOfctTUoxWkVFN3Y4b3M
[+] [-] cromulent|9 years ago|reply
http://www.ncl.ac.uk/press/news/2015/10/type2diabetes/
[+] [-] noir_lord|9 years ago|reply
I also had an undiagnosed (despite every test the docs could think off).
I went on a 1500 calorie a day diet for 7 months and dropped weight from 245lbs to 185lbs (I'm 6 foot) at the next doc appointment indicators where all in normal range and at the most recent they where all excellent for someone my age.
Diet for this 7 months was cottage cheese, veg, nuts and rolled oat porridge with either chicken or fish and veg.
No fruit, lots of supplements and a protein shake before bed.
First month was grim I felt terrible all the time but every month after was easier.
[+] [-] DrScump|9 years ago|reply
http://www.cell.com/cell/pdf/S0092-8674(17)30130-7.pdf
Details on the human feedings:
"The human version of the FMD is a propriety formulation belonging to L-Nutra (http://l-nutra.com/prolon/). It is a plant-based diet designed to attain fasting-like effects on the serum levels of IGF-I, IGFBP1, glucose and ketone bodies while providing both macro- and micronutrients to minimize the burden of fasting and adverse effects (Brandhorst et al., 2015). Day 1 of the FMD supplies ∼4600 kJ (11% protein, 46% fat, 43% carbohydrate), whereas days 2-5 provide ∼3000 kJ (9% protein, 44% fat, 47% carbohydrate) per day. The FMD comprises proprietary formulations of vegetable-based soups, energy bars, energy drinks, chip snacks, tea, and a supplement providing high levels of minerals, vitamins and essential fatty acids (Figure S3). All items to be consumed per day were individually boxed to allow the subjects to choose when to eat while avoiding accidentally consuming components of the following day. For the human subjects, a suggested FMD meal plan was provided that distributes the study foods to be consumed as breakfast, lunch, snacks, and dinner. (See lists below for ingredients and supplements)"
[+] [-] hajderr|9 years ago|reply
All guys/gals with any sort of disease, I pray you all get well and better soon!
[+] [-] johnspiral|9 years ago|reply
[+] [-] llccbb|9 years ago|reply
[+] [-] eyugwefuy|9 years ago|reply
Also, it's impractical to fast when you have work to do and meetings. You risk becoming cranky and grumpy and pissing colleagues off. Better to fast when you have a day off or at night.
[+] [-] amelius|9 years ago|reply
Ok, where can I find more information?
[+] [-] hownottowrite|9 years ago|reply
It's called a fast mimicking diet or FMD.
Quantified Bob took it on last year: https://www.quantifiedbob.com/2016/04/fasting-mimicking-diet...
[+] [-] JustSomeNobody|9 years ago|reply
[+] [-] gukov|9 years ago|reply
[+] [-] perseusprime11|9 years ago|reply
[+] [-] overcast|9 years ago|reply
[+] [-] dgut|9 years ago|reply
[+] [-] sdiepend|9 years ago|reply
[+] [-] mrfusion|9 years ago|reply
[+] [-] consp|9 years ago|reply
Many old people will get it (Type 2) anyway since the pancreas is simply out of juice, but with relatively simple medication it can be managed. Eating like a fat pig will definitely accelerate the reduction in betacell insulin production capacity and increase the insulin resistance of other cells as described above (nice feedback effect).
[+] [-] ak39|9 years ago|reply
[+] [-] cowpewter|9 years ago|reply
[+] [-] dghughes|9 years ago|reply