Samenvatting

Background: Diabetes mellitus is considered the fifth in the top five causes of noncommunicable disease related deaths in the world. Treatment ranges from lifestyle changes to medication. Intermittent fasting (IF) shows glucose lowering results in rats and might be a possibility for human therapy. Objectives: To identify the ability of IF to decrease glycemic markers in adults as well as to study the potential differences between IF and regular dietary restriction (DR). Data sources: An English literature search is done in PubMed. Study selection: Published articles that examined the effects of any kind of IF compared to baseline measurements of blood glucose, insulin and any form of insulin resistance or sensitivity were used in this review, as long as they specified the prescribed caloric restriction (CR) and conducted the research on adult, not pregnant and cancer free humans. Data extraction: Data such as differences in glucose, insulin and insulin resistance/sensitivity were extracted and glucose and insulin were converted to mg/dl and mU/l, respectively, when their current format did not correspond. First author name, study length, intervention type and rate of CR were also collected. Some data was displayed as mean±standard deviation (SD), when SD was provided. Results: A total of eleven studies were included. Six out of eleven studies showed significant results in blood glucose, insulin or insulin sensitivity levels. In ad libitum IF, significant differences were found in 24-hour glucose levels. Insulin levels ranged from -3.4±1.6 mU/l to +4.5±1.6 mU/l, homeostatic model of assessment-insulin resistance (HOMA-IR) levels ranged from -0.84±0.42 to +1.09±0.43, insulinogenic index (IGI) increased by 14±7, incremental Area Under the Curve ratio (iAUC) decreased by 36±10 and Matsuda index (M/I) decreased by 2.3 units. Differences compared to DR ranged from -7.2 mg/dl to + 5.7 mg/dl in glucose, 4.7 mU/l to +0.7 mU/l in insulin and -0.9 to +0.3 in HOMA-IR. Conclusion: IF with a CR is able to reduce blood glucose and insulin, but was not superior to DR.