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Is Intermittent Fasting Safe With Type 2 Diabetes?
Wellness Path

Is Intermittent Fasting Safe With Type 2 Diabetes?

September 18, 2026 3 Min Read
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Potential Drawback of Intermittent Fasting: It May Harm Blood Sugar Control

On the other hand, some experts say that intermittent fasting carries risks, especially for people who need to keep their blood sugar levels stable. For starters, intermittent fasting can result in hypoglycemia, not to mention issues such as fatigue.

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Time-restricted eating and other forms of intermittent fasting may also cause people to make poor dietary choices, which can have the opposite effect on their waistline and blood sugar. If you haven’t eaten for hours, you may be more inclined to reach for a carb-heavy pastry or plate of pasta, for instance.

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“Blood sugar management can be a real concern with intermittent fasting for people with type 2 diabetes,” Sheth says. “That’s why it’s important to discuss intermittent fasting with your physician, monitor your blood sugar closely, and know that your medications may need to be adjusted as well.” Your dietitian or a certified diabetes educator can guide and support you through this process,” she says.

A plan that severely restricts a person’s calories or asks them to skip meals can be hard to stick with long term, too, says Ruth S. Pupo, CDCES, who practices at Adventist Health White Memorial in Los Angeles.

Another risk of intermittent fasting for people with diabetes is hypoglycemia, or low blood sugar. One study found hypoglycemia, but only in participants taking sulfonylureas or insulin; the number of episodes was comparable in the group that fasted and in the group that didn’t fast (control group). In another study included in the same review, hypoglycemia occurred only in a participant in the control group.

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Another review, however, found that fasting participants in one study faced a significant increase in severe hypoglycemic episodes, particularly those taking sulfonylureas or insulin. This complication can be life threatening, so it’s important to take precautions to prevent it. People who take these medications may not be candidates for an intermittent fasting diet or will need to adjust their treatment regimens and glucose monitoring with the advise of a physician before starting to fast.

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Certain people, such as those who are pregnant or breastfeeding or have an underlying disease or medical condition, should also avoid intermittent fasting, Pupo says. “Anytime you have a higher demand for more nutrition, you don’t want to do a fast,” she says. People who are pregnant or breastfeeding require extra calories for themselves and their babies, Pupo says, and fasting can cause them to run out of glucose for energy and instead burn fat and muscle.

What’s more, if a pregnant person overproduces ketones (a compound that is produced when the body uses fat for fuel), studies on animals suggest the effect can be harmful to both the parent and the fetus. Intermittent fasting may also not be safe for older people with type 2 diabetes who have other health conditions. They should speak with their doctor before changing their diet.

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Some people with diabetes also run the risk of developing diabetic ketoacidosis, or DKA. This arises when your body doesn’t have enough insulin to move blood sugar into your cells for use as energy. When that happens, your liver responds by producing too many ketones, which can build up in the body, damaging the kidneys and causing brain swelling, Pupo says. DKA may even lead to a diabetic coma or death, she says.

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Research has shown that there may be a link between intermittent fasting, used in conjunction with a keto diet, and DKA.

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Regardless of whether you have diabetes, cutting out meals or restricting entire food groups can cause nutritional deficiencies. Without proper nutrition, particularly protein, there’s also a risk for muscle mass loss. “When you really deprive the body of nutrients, your body not only breaks down fat but muscle as well,” Pupo says.

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