Can intermittent fasting prevent diabetes-related blindness?

Diabetes
intermittent fasting

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Since retinopathy is a diabetes-related disease and intermittent fasting has been found to help diabetic patients, a research team investigated the role of intermittent fasting on retinopathy.

Diabetes-related blindness, known as retinopathy, affects over 4 million Americans. It is related to complications in the cells of the retina which is followed by alterations in the blood vessels that supply these cells with nutrients. Therapies for retinopathy include surgery and injection of antibodies; however, these are only used to treat late-stage disease.

Strategies for combating early-stage retinopathy are limited and include changes in diet. Reducing caloric intake and undergoing intermittent fasting are some forms of prevention of diabetes and obesity. Reduction of caloric intake may also lead to other side effects such as fatigue, immune suppression and higher chances of contracting viruses. In contrast, intermittent fasting does not have these side effects.

The gut environment plays a large role in metabolism through the generation of bile acids which help cells function. It has been clearly demonstrated that people with diabetes have modifications in their gut environment which could influence sugar metabolism.  Whether intermittent fasting may help in the prevention of retinopathy is not yet known. An American research team wanted to ask how intermittent fasting affects diabetic-related retinopathy and they published their findings recently in the online Diabetes journal.

Intermittent fasting improved survival and decreased retinopathy

For the study, they used a diabetes mouse model to examine the effects of long-term intermittent fasting on retinopathy. They analyzed blood vessels, the gut environment, colon, plasma and the bile acid contents. They found that intermittent fasting on diabetic mice significantly improved survival and they saw a decrease in retinopathy. They thought that this could be due to alteration of the gut environment following intermittent fasting, which in turn was producing valuable metabolic agents preventing retinopathy.

Intermittent fasting may prevent retinopathy through changes in the gut environment

Further investigation of the bile acid contents revealed that there was an increase in an agent known as TUDCA, which has been demonstrated to be a retinal protective bile acid. In conclusion, their results demonstrated that intermittent fasting can prevent retinopathy through the role that it plays in changing the gut environment towards increasing the production of an important bile acid which protects retinal cells.

This data highlights some results that may prove clinically significant in retinopathy patients. It suggests that changes in diet, such as the use of intermittent fasting in people with diabetes can improve the gut environment. The researchers also demonstrated a new way of producing beneficial bile acids for retinopathy patients.

Written by Ingrid Qemo, PhD

Reference: Beli, E., Yan, Y., Moldovan, L., et al. 2018. Restructuring of the gut microbiome by intermittent fasting prevents retinopathy and prolongs survival of db/db mice. Diabetes. https://doi.org/10.2337/db18-0158

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