CC BY 4.0 · Journal of Health and Allied Sciences NU
DOI: 10.1055/s-0044-1778717
Brief Report

Therapeutic Fasting and Vitamin D Levels: A New Dimension in Type 2 Diabetes Mellitus Prevention and Management—A Brief Report

Pradeep M.K. Nair
1   Department of Research, Sant Hirdaram Medical College of Naturopathy & Yogic Sciences for Women, Bhopal, Madhya Pradesh, India
,
Karishma Silwal
2   Department of Naturopathy, Sant Hirdaram Yoga & Nature Cure Hospital, Bhopal, Madhya Pradesh, India
,
Prakash Babu Kodali
3   Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India
,
Gulab Rai Tewani
2   Department of Naturopathy, Sant Hirdaram Yoga & Nature Cure Hospital, Bhopal, Madhya Pradesh, India
› Author Affiliations
Funding None.

Abstract

Introduction Studies link hypovitaminosis D to be significantly associated with poor glycemic control, heightened inflammation, and risk of complications. Studies recommend fasting or calorie restriction as a useful measure to achieve diabetic reversal. The present study explores if therapeutic fasting is associated with improvement in the vitamin D levels and other clinical outcomes related to type 2 diabetes mellitus (T2DM).

Methods This observational study included 26 T2DM patients exposed to a 10-day medically supervised fasting (≈ 500–1000 Kcal/day) in a complementary medicine facility. Levels of vitamin D, B12, fasting blood sugar (FBS), blood pressure, anthropometric measures, World Health Organization Quality of Life, disease perception (Brief Illness Perception Questionnaire), and self-reported vitality were measured at the baseline and the 10th day.

Results Significant improvement in the levels of vitamin D (p = 0.000), B12 (p = 0.03), and reduction in FBS levels (p = 0.001), blood pressure, body mass index, waist and hip circumference (p ≤ 0.05), and improvement in quality of life, vitality, and disease perception (p < 0.001) were observed by the end of 10th day. FBS shared a negative correlation with vitamin D levels (males r = –0.1, females r = –0.48).

Conclusion The present findings provide insights into the probable mechanisms by which therapeutic fasting modulates the progression of T2DM. Nevertheless, large-scale randomized controlled trials are warranted to validate the present findings.

Ethics Approval

The study was approved by the institutional ethics committee of Sant Hirdaram Medical College for Naturopathy & Yogic Sciences (F.No:12/SHMCNYS/IEC/P35), Bhopal, Madhya Pradesh, India.


Consent to Participate

All the participants signed a written consent to express their consent to participate in the study.


Availability of Data and Material

The data will be made available on request to the corresponding author.




Publication History

Article published online:
22 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Chandrupatla SG, Khalid I, Muthuluri T, Dantala S, Tavares M. Diabetes and prediabetes prevalence among young and middle-aged adults in India, with an analysis of geographic differences: findings from the National Family Health Survey. Epidemiol Health 2020; 42: e2020065
  • 2 Madhu SV, Aslam M, Mishra BK, Gupta A, Jhamb R. Association of 25 (OH) vitamin D and leptin in individuals with insulin resistance. Indian J Endocrinol Metab 2022; 26 (05) 435-438
  • 3 Ahmadieh H, Azar ST, Lakkis N, Arabi A. Hypovitaminosis d in patients with type 2 diabetes mellitus: a relation to disease control and complications. ISRN Endocrinol 2013; 2013: 641098
  • 4 Kadowaki S, Norman AW. Pancreatic vitamin D-dependent calcium binding protein: biochemical properties and response to vitamin D. Arch Biochem Biophys 1984; 233 (01) 228-236
  • 5 Fadda GZ, Akmal M, Lipson LG, Massry SG. Direct effect of parathyroid hormone on insulin secretion from pancreatic islets. Am J Physiol 1990; 258 (6 Pt 1): E975-E984
  • 6 Riachy R, Vandewalle B, Kerr Conte J. et al. 1,25-dihydroxyvitamin D3 protects RINm5F and human islet cells against cytokine-induced apoptosis: implication of the antiapoptotic protein A20. Endocrinology 2002; 143 (12) 4809-4819
  • 7 Giulietti A, van Etten E, Overbergh L, Stoffels K, Bouillon R, Mathieu C. Monocytes from type 2 diabetic patients have a pro-inflammatory profile. 1,25-Dihydroxyvitamin D(3) works as anti-inflammatory. Diabetes Res Clin Pract 2007; 77 (01) 47-57
  • 8 Pittas AG, Jorde R, Kawahara T, Dawson-Hughes B. Vitamin D supplementation for prevention of type 2 diabetes mellitus: to D or not to D?. J Clin Endocrinol Metab 2020; 105 (12) 3721-3733
  • 9 Wilhelmi de Toledo F, Grundler F, Sirtori CR, Ruscica M. Unravelling the health effects of fasting: a long road from obesity treatment to healthy life span increase and improved cognition. Ann Med 2020; 52 (05) 147-161
  • 10 Saeed M, Ali M, Zehra T, Haider Zaidi SA, Tariq R. Intermittent fasting: a user-friendly method for type 2 diabetes mellitus. Cureus 2021; 13 (11) e19348
  • 11 Tewani GR, Silwal K, Sharma G. et al. Effect of medically supervised prolonged fasting therapy on vitamin D, B12, body weight, body mass index, vitality and quality of life: a randomized control trial. Nutr Metab Insights 2022 ;15:11786388221130560
  • 12 Arankalle D, Tewani GR, Nair PM, Wardle J. Outcomes of a medically supervised fasting module on healthy females in a controlled residential environment: a brief report. Perm J 2021; 25 (04) 21
  • 13 Mk P, Kodali PB, Tewani GR, Sharma H, Nagarkar A. Physiological and psychological effects of medically supervised fasting in young female adults: an observational study. Cureus 2023; 15 (07) e42183
  • 14 Cho Y, Hong N, Kim KW. et al. The effectiveness of intermittent fasting to reduce body mass index and glucose metabolism: a systematic review and meta-analysis. J Clin Med 2019; 8 (10) 1645
  • 15 Yuan X, Wang J, Yang S. et al. Effect of intermittent fasting diet on glucose and lipid metabolism and insulin resistance in patients with impaired glucose and lipid metabolism: a systematic review and meta-analysis. Int J Endocrinol 2022; 2022: 6999907
  • 16 Suzuki A, Kotake M, Ono Y. et al. Hypovitaminosis D in type 2 diabetes mellitus: association with microvascular complications and type of treatment. Endocr J 2006; 53 (04) 503-510
  • 17 Cigolini M, Iagulli MP, Miconi V, Galiotto M, Lombardi S, Targher G. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care 2006; 29 (03) 722-724
  • 18 Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Ther Adv Endocrinol Metab 2013; 4 (04) 122-128
  • 19 Żychowska M, Rola R, Borkowska A. et al. Fasting and exercise induce changes in serum vitamin D metabolites in healthy men. Nutrients 2021; 13 (06) 1963
  • 20 Alam I, Gul R, Chong J. et al. Recurrent circadian fasting (RCF) improves blood pressure, biomarkers of cardiometabolic risk and regulates inflammation in men. J Transl Med 2019; 17 (01) 272
  • 21 Cannell JJ, Grant WB, Holick MF. Vitamin D and inflammation. Dermatoendocrinol 2015; 6 (01) e983401
  • 22 Kibirige D, Mwebaze R. Vitamin B12 deficiency among patients with diabetes mellitus: is routine screening and supplementation justified?. J Diabetes Metab Disord 2013; 12 (01) 17
  • 23 Kos E, Liszek MJ, Emanuele MA, Durazo-Arvizu R, Camacho P. Effect of metformin therapy on vitamin D and vitamin B12 levels in patients with type 2 diabetes mellitus. Endocr Pract 2012; 18 (02) 179-184
  • 24 de Jager J, Kooy A, Lehert P. et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ 2010; 340 (7757) c2181
  • 25 Bauman WA, Shaw S, Jayatilleke E, Spungen AM, Herbert V. Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin. Diabetes Care 2000; 23 (09) 1227-1231
  • 26 Norman AW. Intestinal calcium absorption: a vitamin D-hormone-mediated adaptive response. Am J Clin Nutr 1990; 51 (02) 290-300
  • 27 Beleslin B, Cirić J, Zarković M, Vujović S, Trbojević B, Drezgić M. The effects of three-week fasting diet on blood pressure, lipid profile and glucoregulation in extremely obese patients [in Serbian]. Srp Arh Celok Lek 2007; 135 (7-8): 440-446
  • 28 Noon MJ, Khawaja HA, Ishtiaq O. et al. Fasting with diabetes: a prospective observational study. BMJ Glob Health 2016; 1 (02) e000009
  • 29 Aarthy R, Mikocka-Walus A, Pradeepa R, Anjana RM, Mohan V, Aston-Mourney K. Quality of life and diabetes in India: a scoping review. Indian J Endocrinol Metab 2021; 25 (05) 365-380
  • 30 Anic K, Schmidt MW, Furtado L. et al. Intermittent fasting-short- and long-term quality of life, fatigue, and safety in healthy volunteers: a prospective, clinical trial. Nutrients 2022; 14 (19) 4216