I am 45 years old, diagnosed with type 2 diabetes about five years ago, and my last hemoglobin A1c was 6.8%. Is there any healthy way to do a one to three day water-only fast?

Yours is an interesting question. Fasting has a long tradition, in religious, political and health connections. Short fasts are not harmful, per se, to healthy adults of normal weight or above. However, you ask if there is a “healthy” way to do a three-day water-only fast. I think it would depend on your goal for fasting and on what you consider “healthy.” Water-only fasts force the body to burn fat and protein stores to meet energy needs. When this happens, there is inevitably some ketosis and some muscle lost. It’s hard to see how these effects can be called “healthy.” Some people fast to “detoxify.” This is questionable in the minds of some medical authorities since many environmental toxins are held in body fat stores and so breaking down fat at a rapid rate would be expected to release those toxins into the system at a rapid rate. In persons who are underweight, weakened or ill, that would be undesirable, although healthy persons with robust livers and kidneys can probably eliminate undesirable chemicals pretty efficiently — we do it every day in a world filled with a variety of substances not meant to be part of the human body. Juice fasts eliminate ketosis as a side effect by supplying carbohydrate calories along with liquids.

In terms of your diabetes, the advisability and cautions related to a fast depend, first of all, on what medicines you are currently taking. With insulin and with some pills, your risk for hypoglycemia would be extremely high when fasting. If you are taking medicines for your diabetes, you need a plan for testing blood sugar and decreasing doses as you go into the fast. Please consult with your health care provider for the specific cautions with your own medicines.

Finally, heart disease, including the potential for “silent” heart attacks, is a common problem in people with type 2 diabetes. A fast could be of much greater concern in a person with heart disease and so, if you haven’t had one as part of your ongoing diabetes care, I’d recommend a baseline electrocardiogram and medical clearance before proceeding.

I’m sure this sounds like a lot of work and thought. It is, but I’m glad you asked so that you can make this decision in the way that best suits your situation. Best of luck in reaching your goals!

BB