The link between intermittent fasting and insulin resistance
Your body is incredible.
It works constantly to keep you alive and functioning. Your hormones — chemical messengers that coordinate bodily functions by carrying signals through the blood to the organs, muscles, tissues, and cells — play a huge role in this.
There are over 50 different hormones in the human body, and in the context of weight loss or gain, insulin is thought to be one of the most significant.
Insulin controls the amount of sugar in your blood. When insulin levels peak too high too often, the result can be insulin resistance, a condition which, left unchecked, can lead to weight gain, type 2 diabetes, and heart problems.
So, does intermittent fasting help with insulin resistance? Is intermittent fasting even good for those with insulin resistance?
Let’s explore the connection between intermittent fasting and insulin resistance to find out.
How insulin works
Your body needs glucose (sugar) for energy, but your cells can’t absorb glucose directly. That’s where insulin comes in.[5] Here’s how it works.
When you eat, your body turns the carbohydrates in your food into glucose. Your blood sugar rises, signaling your pancreas to release insulin.
Insulin acts like a kind of shuttle bus, helping glucose enter your muscle, fat, and liver cells. Once there, it’s used for energy or stored for when your blood sugar runs low.
This process keeps your blood sugar levels balanced and within a healthy range, stopping them from getting too high (hypoglycemia) or too low (hypoglycemia).[1]
What is insulin resistance?
Insulin resistance is when your body no longer responds to insulin,[6] so your cells can’t take in glucose, and your blood sugar levels stay elevated as a result.
Your pancreas continues to release insulin to try and reduce your blood sugar to a healthy level. But, if it can’t overcome the resistance, the cells in the pancreas that produce insulin can eventually wear out.
How does insulin resistance develop?
Insulin resistance can develop from several causes.
Carrying extra body weight
Carrying extra body weight, particularly around your stomach, can increase the likelihood of insulin resistance. Fat cells release inflammatory molecules (like cytokines and adipokines), which trigger inflammation and stop insulin from effectively communicating with your cells.[7] Higher levels of free fatty acids in the blood can also reduce insulin’s ability to drive glucose into your muscle and liver cells.
What you eat
Eating high-carbohydrate foods, particularly those high in refined sugar, leads to a rapid rise in blood sugar levels, resulting in a surge in insulin production.[8] When this happens too frequently, cells may suppress their insulin receptors and become less responsive to insulin’s signals.
Chronic stress
Stress triggers the release of stress hormones,[9] like cortisol and adrenaline, which can increase blood sugar levels and decrease glucose uptake. Chronic (i.e., long-term) stress means this happens often, resulting in insulin resistance, just like in the example above. High cortisol levels can also lead to increased belly fat, which compounds the issue.[10]
Lack of physical activity
Regular exercise makes your muscle cells more responsive to insulin.[11] But when you’re not active, your muscles don’t use glucose effectively. So, being too sedentary means your cells can become less sensitive to insulin’s attempts to get glucose into them.
Poor sleep
Not getting enough quality sleep can disrupt your natural circadian rhythms, which changes how effectively your body processes blood sugar. Research suggests that irregular sleep affects the hormones involved in blood sugar control, leading to higher fasting glucose levels and lower insulin sensitivity.
Intermittent fasting, as we’ll see, can be a real help with several of these factors. If you’re already eager to give it a go, take our Simple quiz, and we’ll help you kick off your intermittent fasting journey!
Insulin resistance symptoms
If you had insulin resistance, how would you know? These are the symptoms to look out for:
Constant hunger
Feeling hungry regularly — even shortly after eating a meal — can be a sign that your cells aren’t absorbing enough glucose and your body is sending the signal that it needs more.
Extreme thirst
If you notice you’re drinking a lot more water than usual, it could be because your kidneys are working harder to remove excess sugar from your bloodstream.
Persistent fatigue
When your cells don’t use glucose effectively, your energy levels can dip, leading to persistent fatigue and low energy throughout the day.
Needing to pee a LOT
Having too much sugar in your blood means your kidneys have to work harder to get rid of it … and you take a lot of trips to the bathroom as a result.
Unexplained weight gain
Having insulin resistance means your pancreas will produce more insulin to try and resolve the problem and help glucose get into your cells. This elevated insulin level can lead to more calories being stored as fat.
Tingling sensations
Insulin resistance can lead to nerve damage (a condition known as neuropathy) in your hands and feet, which you’ll initially experience as tingling sensations.
Increased risk of infection
When your blood sugar levels aren’t well managed, it can compromise your immune system, leaving you more susceptible to infections and illnesses.
If you’re experiencing any of these symptoms and are concerned you might have insulin resistance, speak to your doctor.
The dangers of insulin resistance
Insulin resistance is pretty serious business. Left untreated, it can lead to a number of significant health challenges.
Type 2 diabetes
Persistent insulin resistance can ultimately result in type 2 diabetes, which in turn can lead to other serious health complications.[2]
Cardiovascular disease
Insulin resistance is associated with an increased risk of heart disease. It can lead to high blood pressure, unhealthy cholesterol levels, and the development of atherosclerosis (hardening of the arteries), which can result in heart attacks and strokes.[12]
Obesity
Insulin resistance often promotes weight gain, particularly around the belly, which can lead to obesity. Obesity, in turn, further exacerbates insulin resistance, creating a vicious cycle.[13]
Polycystic ovary syndrome (PCOS)
Many people with PCOS have insulin resistance. This can lead to hormonal imbalances, irregular periods, and difficulties with fertility.
Non-alcoholic fatty liver disease (NAFLD)
Insulin resistance can lead to the accumulation of fat in the liver, resulting in NAFLD. This condition can progress to more severe liver damage if left unmanaged.[14]
Kidney disease
Long-term insulin resistance can damage the blood vessels in the kidneys, potentially leading to kidney disease or even kidney failure.[15]
Neuropathy
As mentioned earlier, insulin resistance can contribute to nerve damage, leading to neuropathy, which can cause pain, numbness, and potentially long-term tissue damage.[16]
Vision problems
High blood sugar levels related to insulin resistance can harm the blood vessels in the eyes, leading to diabetic retinopathy, which can result in vision problems or even blindness.[16]
Cancer
Some research suggests a link between insulin resistance and an increased risk of certain cancers, including breast,[17] colon,[18] and pancreatic cancer.[19]
Autoimmune disorders
Insulin resistance may be associated with autoimmune conditions, such as rheumatoid arthritis and lupus.[20,21]
Chronic inflammation
Insulin resistance can cause chronic inflammation (also known as oxidative stress) throughout the body, contributing to a range of health issues.
Intermittent fasting and insulin
Intermittent fasting is an eating plan that involves alternating periods of fasting and eating. Each day, you have a period of time where you eat and a period of time where you don’t. This regular period of not eating is how intermittent fasting can positively impact your insulin levels.
Every time you eat, your blood sugar rises, and your body has to balance it by releasing insulin. When you overeat frequently, your caloric intake is regularly too high, or you eat too many refined carbohydrate foods, your blood sugar control system can get overwhelmed and stop working properly.
Intermittent fasting gives your body a daily break from its blood sugar management responsibilities. When you don’t eat, your pancreas doesn’t have to produce and release insulin because there’s no blood sugar to manage.
If this already has you curious to see the health benefits for yourself, take our Simple quiz to get started. We’ll recommend the right fasting schedule for you and make sure you have all the tools, information, and support you need to get started safely and start getting results quickly!
How can intermittent fasting reduce insulin resistance?
The effect of intermittent fasting on insulin sensitivity has been debated for several years.[22]
A 2018 study investigating the connection between insulin resistance and intermittent fasting suggested fasting could play a role in reversing insulin resistance.[23]
Another study found that in adults living with type 2 diabetes, TRE resulted in 18% reduction in HbA1c, 15% reduction in fasting glucose levels, and a 14% reduction in insulin resistance.[24]
Several studies suggest that fasting is just as effective as traditional calorie restriction diets in helping people lose weight and reduce the risk of developing type 2 diabetes.[25]
Best intermittent fasting schedules to reduce insulin resistance
A 2018 study showed that the 18:6 fasting schedule (fasting for 18 hours and eating within a six-hour window daily) improved insulin sensitivity in men with prediabetes.[22] This review showed intermittent fasting improved insulin sensitivity regardless of fasting schedule.[26]
There is no one-size-fits-all when it comes to intermittent fasting — the best intermittent fasting schedule for reducing blood sugar is the schedule that works for you!
Is intermittent fasting safe?
If you are thinking of trying intermittent fasting for insulin resistance, check whether it’s safe for you before you start. For some people, getting the go-ahead from their doctor is imperative. This means you if you:
- have a medical condition
- take prescription medications
- are extremely active
- are pregnant, breastfeeding, or trying to conceive
- have a body mass index (BMI) < 18.5
- have (or are at risk of having) an eating disorder or have a history of one
- are under 18 years old, or are 80 years old or more
If it’s safe for you to try, know that some intermittent fasting schedules are safer than others:
- We recommend fasting for a few hours daily (known as TRE, or time-restricted eating) and keeping your fasts to an 18-hour limit.
- We don’t recommend fasting schedules like alternate day fasting, 5:2, Eat Stop Eat, water fasting, or dry fasting.
Intermittent fasting isn’t a “fix” for insulin resistance. It can help, however. Studies show that intermittent fasting can reduce blood sugar and insulin resistance by 3% to 6% over 8 to 12 weeks in prediabetic individuals.[25]
During a 16-hour fast, your body enters a state of fasting metabolism.[27] Initially, it depletes stored glycogen for energy, then shifts to burning stored fat for fuel. Insulin levels drop, promoting fat breakdown. Autophagy, a cellular cleansing process, may also occur. All of this can aid weight loss and improve metabolic health (and interestingly, it seems that intermittent fasting does not slow metabolism).
There is no quick fix for insulin resistance, as it often develops over time due to various risk factors. However, lifestyle changes — like eating a balanced diet (which could include low glycemic index foods), intermittent fasting, getting regular exercise, managing stress, and getting adequate sleep — can improve insulin sensitivity and help manage insulin resistance in the long term.[28]
Intermittent fasting can be effective in managing and preventing prediabetes.[29] However, intermittent fasting may not work for everyone, so talk to your doctor before trying it.
Yes, prolonged starvation can decrease insulin levels in the body.[30] As the body depletes its glycogen stores and relies on fat for energy, insulin production decreases to conserve glucose for essential functions. However, this is an extreme state and not a recommended approach for managing insulin levels.
- Li M, Chi X, Wang Y, Setrerrahmane S, Xie W, Xu H. Trends in insulin resistance: insights into mechanisms and therapeutic strategy. Signal Transduct Target Ther. 2022 Jul 6;7(1):216.
- Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. StatPearls Publishing; 2023.
- Albosta M, Bakke J. Intermittent fasting: is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians. Clin Diabetes Endocrinol. 2021 Feb 3;7(1):3.
- Dong TA, Sandesara PB, Dhindsa DS, Mehta A, Arneson LC, Dollar AL, et al. Intermittent Fasting: A Heart Healthy Dietary Pattern? Am J Med. 2020 Aug;133(8):901–7.
- Rahman MS, Hossain KS, Das S, Kundu S, Adegoke EO, Rahman MA, et al. Role of Insulin in Health and Disease: An Update. Int J Mol Sci [Internet]. 2021 Jun 15;22(12).
- Wilcox G. Insulin and insulin resistance. Clin Biochem Rev. 2005 May;26(2):19–39.
- Wondmkun YT. Obesity, Insulin Resistance, and Type 2 Diabetes: Associations and Therapeutic Implications. Diabetes Metab Syndr Obes. 2020 Oct 9;13:3611–6.
- Macdonald IA. A review of recent evidence relating to sugars, insulin resistance and diabetes. Eur J Nutr. 2016 Nov;55(Suppl 2):17–23.
- Yaribeygi H, Maleki M, Butler AE, Jamialahmadi T, Sahebkar A. Molecular mechanisms linking stress and insulin resistance. EXCLI J. 2022 Jan 24;21:317–34.
- Ukkola O, Pérusse L, Chagnon YC, Després JP, Bouchard C. Interactions among the glucocorticoid receptor, lipoprotein lipase and adrenergic receptor genes and abdominal fat in the Québec Family Study. Int J Obes Relat Metab Disord. 2001 Sep;25(9):1332–9.
- Lin Y, Fan R, Hao Z, Li J, Yang X, Zhang Y, et al. The Association Between Physical Activity and Insulin Level Under Different Levels of Lipid Indices and Serum Uric Acid. Front Physiol. 2022 Feb 2;13:809669.
- Ormazabal V, Nair S, Elfeky O, Aguayo C, Salomon C, Zuñiga FA. Association between insulin resistance and the development of cardiovascular disease. Cardiovasc Diabetol. 2018 Aug 31;17(1):122.
- Patel P, Abate N. Body fat distribution and insulin resistance. Nutrients. 2013 Jun 5;5(6):2019–27.
- Cetin EG, Demir N, Sen I. The Relationship between Insulin Resistance and Liver Damage in non-alcoholic Fatty Liver Patients. Sisli Etfal Hastan Tip Bul. 2020 Dec 11;54(4):411–5.
- CDC. Diabetes and chronic kidney disease [Internet]. Centers for Disease Control and Prevention. 2023 [cited 2023 Nov 3].
- Grote CW, Wright DE. A Role for Insulin in Diabetic Neuropathy. Front Neurosci. 2016 Dec 23;10:581.
- Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr. 2001 Nov;131(11 Suppl):3109S – 20S.
- Goodwin PJ, Ennis M, Pritchard KI, Trudeau ME, Koo J, Madarnas Y, et al. Fasting insulin and outcome in early-stage breast cancer: results of a prospective cohort study. J Clin Oncol. 2002 Jan 1;20(1):42–51.
- Hammarsten J, Högstedt B. Clinical, haemodynamic, anthropometric, metabolic and insulin profile of men with high-stage and high-grade clinical prostate cancer. Blood Press. 2004;13(1):47–55.
- Manrique-Arija S, Ureña I, Valdivielso P, Rioja J, Jiménez-Núñez FG, Irigoyen MV, et al. Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis. Clin Rheumatol. 2016 Jan;35(1):43–53.
- Erdozain JG, Ruiz Irastorza G. Síndrome metabólico en pacientes con lupus eritematoso sistémico: causas y consecuencias. Med Clin . 2015 Apr 8;144(7):309–11.
- Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CM. Early Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with Prediabetes. Cell Metab. 2018 Jun 5;27(6):1212–21.e3.
- Furmli S, Elmasry R, Ramos M, Fung J. Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin. BMJ Case Rep [Internet]. 2018 Oct 9;2018.
- Che T, Yan C, Tian D, Zhang X, Liu X, Wu Z. Time-restricted feeding improves blood glucose and insulin sensitivity in overweight patients with type 2 diabetes: a randomised controlled trial. Nutr Metab . 2021 Oct 7;18(1):88.
- Barnosky AR, Hoddy KK, Unterman TG, Varady KA. Intermittent fasting vs daily calorie restriction for type 2 diabetes prevention: a review of human findings. Transl Res. 2014 Oct;164(4):302–11.
- Cho Y, Hong N, Kim KW, Cho SJ, Lee M, Lee YH, et al. The Effectiveness of Intermittent Fasting to Reduce Body Mass Index and Glucose Metabolism: A Systematic Review and Meta-Analysis. J Clin Med Res [Internet]. 2019 Oct 9;8(10).
- Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, et al. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity . 2018 Feb;26(2):254–68.
- Uusitupa M, Khan TA, Viguiliouk E, Kahleova H, Rivellese AA, Hermansen K, et al. Prevention of Type 2 Diabetes by Lifestyle Changes: A Systematic Review and Meta-Analysis. Nutrients [Internet]. 2019 Nov 1;11(11).
- Ojo TK, Joshua OO, Ogedegbe OJ, Oluwole O, Ademidun A, Jesuyajolu D. Role of Intermittent Fasting in the Management of Prediabetes and Type 2 Diabetes Mellitus. Cureus. 2022 Sep;14(9):e28800.
- Vendelbo MH, Clasen BFF, Treebak JT, Møller L, Krusenstjerna-Hafstrøm T, Madsen M, et al. Insulin resistance after a 72-h fast is associated with impaired AS160 phosphorylation and accumulation of lipid and glycogen in human skeletal muscle. Am J Physiol Endocrinol Metab. 2012 Jan 15;302(2):E190–200.