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Researchers reviewed more than 225 trials and found intermittent fasting lowers blood sugar and weight—potentially reshaping diabetes treatment guidelines.
What looks like a fad diet might actually be a treatment plan. Roughly 13 percent of American adults now practice intermittent fasting, making it the third most popular diet in the country. Yet the official playbook doctors use to treat diabetes still barely mentions it. That gap is the target of a new article in The Lancet Diabetes & Endocrinology. In it, the three authoring researchers argue it’s time for the American Diabetes Association (ADA) and the International Diabetes Federation (IDF) to formally add intermittent fasting to their clinical guidelines.
For people managing type 2 diabetes, the standard lifestyle advice has long centered on calorie counting – a method with notoriously high drop-off rates. If intermittent fasting works just as well and is easier to stick to, it could become a real option that doctors actively recommend, rather than something patients try on their own without clinical collaboration.
What the researchers found
The authors, led by Krista Varady, PhD, a Professor of Nutrition at the University of Illinois, Chicago, reviewed evidence from more than 225 clinical trials on intermittent fasting, including nearly 40 conducted specifically in people with diabetes or prediabetes.
Their conclusion: across different fasting styles—time-restricted eating, the 5:2 diet, alternate-day fasting, and the fasting-mimicking diet—intermittent fasting reduced a key measure of blood sugar control (called HbA1c) by 0.3-1.2 percent in adults with type 2 diabetes. It also lowered fasting glucose and body weight compared with typical eating patterns, according to ScienceDirect.
Notably, the researchers found intermittent fasting performed about as well as traditional calorie restriction for blood sugar control. Plus, when medications were adjusted properly, the intermittent fasting didn’t raise the risk of dangerous low blood sugar (hypoglycemia).
The ADA gave intermittent fasting a brief nod in its 2023 Standards of Care, acknowledging it can produce modest weight loss. But as of 2026, the organization still hasn’t formally reviewed its effects on blood sugar control specifically, and the IDF’s fasting guidance is limited to religious fasting practices like Ramadan.
Where the evidence runs thin
The picture isn’t uniform across every group. The researchers assessed that there’s insufficient data to recommend the diet to people with type 1 or gestational diabetes.
The authors are also careful to name who should steer clear entirely: pregnant or breastfeeding women, children, anyone with a history of severe hypoglycemia, and, with caution, older adults at risk of muscle loss.
As one of the most common diets in America, intermittent fasting isn’t a fringe idea anymore. The researchers’ bet is that once major guideline bodies catch up too, fasting could become a standard tool doctors reach for, not just something patients discover on their own.
This post originally appeared at inc.com.
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