Therapeutic use of intermittent fasting and ketogenic diet as an alternative treatment for type 2 diabetes in a normal weight woman: a 14-month case study

This case demonstrates the effective and sustainable use of intermittent fasting (IF) and ketogenic diet (KD) in a normal weight patient with type 2 diabetes, who did not attain glycaemic control with a standard care approach. A 57-year-old woman with type 2 diabetes treated with metformin and strict adherence to a standard diabetic diet presented with a haemoglobin A1c (HbA1c) of 9.3%. Within 4 months of transitioning to KD, combined with IF, she achieved glycaemic control off pharmacotherapy, with HbA1c of 6.4. IF regimens started as 24 hours three times per week, followed by 42 hours three times per week, then 42 hours two times per week and 16 hours once per week. A maintenance phase was then begun at 8 months; IF was reduced to 16 hours per day, with 24 hours three times per month, and metformin was restarted. At 14 months, HbA1c reached 5.8%, and body mass index was minimally changed.