Article Text

Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin
  1. Suleiman Furmli1,
  2. Rami Elmasry2,3,
  3. Megan Ramos4,
  4. Jason Fung4,5
  1. 1 Family Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
  2. 2 Saint James School of Medicine, Arnos Vale, Saint Vincent and the Grenadines
  3. 3 Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
  4. 4 Corporate Medical Centre, Scarborough, Ontario, Canada
  5. 5 Department of Medicine, Scarborough Hospital, Scarborough, Ontario, Canada
  1. Correspondence to Dr Suleiman Furmli, furmli55{at}


This case series documents three patients referred to the Intensive Dietary Management clinic in Toronto, Canada, for insulin-dependent type 2 diabetes. It demonstrates the effectiveness of therapeutic fasting to reverse their insulin resistance, resulting in cessation of insulin therapy while maintaining control of their blood sugars. In addition, these patients were also able to lose significant amounts of body weight, reduce their waist circumference and also reduce their glycated haemoglobin level.

  • diet
  • obesity (nutrition)
  • metabolic disorders
  • diabetes
  • endocrine system

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Supplementary materials


  • Contributors SF compiled all patient results and medical records for the purpose of analysing the data; completed 50% of the background literature review to help support the manuscript; assisted in writing approximately 50% of the manuscript. RE assisted in 50% of the background literature search and writing up 50% of the manuscript; created the graphs and figures for the manuscript. MR took all of the patients' measurements and medical histories for each appointment, and ensured that the data were correct and kept up-to-date, safe and confidential; arranged follow-up appointments for the patients and assisted with coaching and motivational interviewing at each visit; organised and retrieved all medical information to complete this study; ensured proper verbal and written patient consent for all three study subjects. JF provided clinical oversight for the management of each patient at each visit, including pharmacological management and deprescribing when needed; provided methodological support including design, analysis and interpretation of the results; proof-read the manuscript entirely at least three times.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.