Saeed Mahreen, Ali Moeez, Zehra Tehreem, Haider Zaidi Saiyed Ali, Tariq Rihab
Internal Medicine, Jamal Noor Hospital, Karachi, PAK.
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2021 Nov 8;13(11):e19348. doi: 10.7759/cureus.19348. eCollection 2021 Nov.
Type 2 diabetes mellitus (T2DM) is an alarmingly rising disorder characterized mainly by insulin resistance and hyperglycemia. Due to the impairment of glucose homeostasis, most subjects present with elevated serum glucose levels, which can lead to several complications, including hospitalizations and even death. Diet quality and quantity are at the heart of its pathogenesis; hence, for the management of this condition, a technique known as intermittent fasting (IF) has been an area of interest for researchers. Different fasting regimens, including alternate-day fasting, religious fasting, and time-restricted fasting, have proven to be of strategic importance for glycemic control due to their physiologic effects. According to case studies and randomized trials, therapeutic fasting has been shown to reverse insulin resistance, resulting in the discontinuance of insulin therapy while maintaining blood sugar levels. Studies on IF have demonstrated their efficacy in glycemic control and other metabolic parameters, including reducing visceral fat and controlling inflammatory mediators and markers such as C-reactive protein (CRP) and interleukin-6 (IL-6), but control in obesity is its most significant effect as it acts as a risk factor for T2DM. Several case studies have shown a reduction in elevated hemoglobin A1c (HbA1c) levels in subjects after fasting, which some believe is due to sirtuin-6 (SIRT6) proteins. SIRT6 proteins are believed to be responsible for blood glucose homeostasis and insulin resistance reversal by increasing its sensitivity. This family of proteins is increased after fasting; hence, further research in this area will help researchers better understand its mechanism of action and potential therapeutic effects on T2DM. With an alarming increase in the incidence of T2DM around the world, a cost-effective strategy is required to control the disease with easy patient compliance, and IF might prove to be the solution.
2型糖尿病(T2DM)是一种发病率急剧上升的疾病,主要特征为胰岛素抵抗和高血糖。由于葡萄糖稳态受损,大多数患者的血清葡萄糖水平升高,这可能导致多种并发症,包括住院甚至死亡。饮食的质量和数量是其发病机制的核心;因此,对于这种疾病的管理,一种称为间歇性禁食(IF)的技术一直是研究人员感兴趣的领域。不同的禁食方案,包括隔日禁食、宗教禁食和限时进食,由于其生理作用,已被证明对血糖控制具有战略重要性。根据案例研究和随机试验,治疗性禁食已被证明可以逆转胰岛素抵抗,从而在维持血糖水平的同时停止胰岛素治疗。对间歇性禁食的研究表明,它们在血糖控制和其他代谢参数方面具有功效,包括减少内脏脂肪以及控制炎症介质和标志物,如C反应蛋白(CRP)和白细胞介素-6(IL-6),但对肥胖的控制是其最显著的效果,因为肥胖是2型糖尿病的一个危险因素。一些案例研究表明,禁食后受试者的糖化血红蛋白(HbA1c)水平升高有所降低,有些人认为这是由于沉默调节蛋白6(SIRT6)蛋白所致。SIRT6蛋白被认为通过增加其敏感性来负责血糖稳态和逆转胰岛素抵抗。这类蛋白在禁食后会增加;因此,该领域的进一步研究将有助于研究人员更好地了解其作用机制以及对2型糖尿病的潜在治疗效果。随着全球2型糖尿病发病率的惊人增长,需要一种具有成本效益的策略来控制这种疾病,并且易于患者依从,而间歇性禁食可能被证明是解决方案。