title: Therapeutic fasting in patients with metabolic syndrome and impaired insulin resistance.
abstract: BACKGROUND
  In this study, we evaluated whether a short- to mid-term fasting therapy (7-18 days) might improve insulin resistance according to the homeostasis model assessment for insulin resistance (HOMA-IR), measured during mid-term (80 days) follow-up observation in patients with metabolic syndrome.
  
  
  METHODS
  In this open label observational study in inpatients, criteria of metabolic syndrome were defined. Before medically controlled Buchinger fasting, a wash-out period for hypoglycemic agents was conducted. Further evaluation was carried out on day 80.
  
  
  RESULTS
  25 patients (13 males, 12 females, mean age 61.3 years) were included in this study (mean fasting duration 11.5 days). Out of 16 inpatients with type 2 diabetes, 4 had been treated with metformin, 3 with insulin, and 1 with glimepiride before the intervention. After therapy, body mass index (BMI), fasting insulin, fasting glucose, and HOMA-IR were all significantly reduced. Compared to baseline, HOMA-IR decreased by 33% in all patients, by 38% in patients with type 2 diabetes, and by 23% in patients without diabetes. At day 80, BMI further improved, while other parameters showed complete (insulin) or partial (glucose, HOMA-IR) rebound. At this time, HOMA-IR values showed an only insignificant improvement in 15% of all patients, in 20% of patients with type 2 diabetes, and in 6% of patients without diabetes. There was no correlation between change in BMI and change in HOMA-IR (r(2) = 0.008, baseline minus day 80). No serious side effects were observed.
  
  
  CONCLUSIONS
  Fasting as a safe and acceptable procedure may cause short- and mid-term improvement of increased insulin resistance (HOMA-IR). Patients with type 2 diabetes benefit more than those without diabetes. A possible clinical significance of this effect should be explored in larger and controlled clinical trials.
authors.affiliation: Department of Internal and Complementary Medicine, Immanuel Hospital, Berlin, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Stange
authors.forename: Christine
authors.initials: C
authors.lastname: Pflugbeil
authors.forename: Andreas
authors.initials: A
authors.lastname: Michalsen
authors.forename: Bernhard
authors.initials: B
authors.lastname: Uehleke
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000503:physiopathology; D005215:Fasting / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000503:physiopathology; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D007328:Insulin