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Efeito do jejum intermitente na diabetes mellitus tipo 2

Authors: Carneiro, Juliana da Silva;

Efeito do jejum intermitente na diabetes mellitus tipo 2

Abstract

Introdução: A diabetes mellitus tipo 2 é a forma mais comum de diabetes e resulta da interação entre fatores genéticos, comportamentais e ambientais. A maioria dos indivíduos com esta doença tem excesso de peso e, portanto, a perda de peso deve ser encorajada. Atualmente, tem-se estudado cada vez mais os efeitos do jejum intermitente, tanto na perda de peso, como na melhoria dos parâmetros antropométricos, fisiológicos e bioquímicos em doentes com diabetes. Esta abordagem envolve períodos alternados de jejum parcial, onde a alimentação é severamente restrita, com períodos de alimentação normal. O jejum intermitente tem mostrado, em seres humanos, uma diminuição da incidência de problemas cardiovasculares, diabetes, doenças reumáticas, síndromes de dor crónica e síndrome metabólica. Este trabalho teve como objetivo realizar uma revisão sistemática da literatura disponível para avaliar se o jejum intermitente constitui uma alternativa viável a curto e/ou médio prazo para doentes com diabetes mellitus tipo 2 e se esta abordagem tem algum tipo de benefício relativamente a uma restrição energética contínua. Material e Métodos: Foi feita uma pesquisa bibliográfica usando a base de dados “PubMed/MEDLINE”, com as palavras chave ‘intermittent fasting’ e ‘type 2 diabetes’ associadas. Foram selecionados ensaios cínicos randomizados e não randomizados. A pesquisa foi completada após análise de algumas referências bibliográficas dos artigos selecionados. Resultados: Da pesquisa selecionaram-se 7 artigos que abordaram o efeito do jejum intermitente em doentes com diabetes mellitus tipo 2. Na maioria dos estudos, o jejum intermitente mostrou melhorias no peso corporal, perímetro abdominal, glicemia em jejum, resistência à insulina, hemoglobina glicada, pressão arterial sistólica e diastólica, perfil metabólico e qualidade de vida. Contudo, outros artigos não chegaram às mesmas conclusões, não mostrando melhorias significativas na hemoglobina glicada, insulina ou índice de resistência à insulina. Discussão: O jejum intermitente mostrou inúmeros benefícios e, comparativamente à restrição energética contínua, mostrou-se uma alternativa bastante eficaz. No entanto, existiram várias limitações, nomeadamente, amostras reduzidas, distribuição por sexos desigual e o facto de alguns dos valores serem autorrelatados. Foi ainda mostrado que as alterações na medicação hipoglicemiante devem ser feitas dependendo do número de dias de jejum e das características dos indivíduos. Conclusões: A literatura sobre o tema é, ainda, escassa e não existem estudos que avaliem os efeitos desta abordagem a longo prazo. Apesar disto, a curto e médio prazo mostrou-se uma alternativa para aqueles doentes que não conseguem fazer uma restrição energética contínua, não se tendo mostrado maior quantidade de episódios de hipoglicemia.

Introduction: Type 2 diabetes mellitus is the most common form of diabetes and is the result of the interaction between genetic, behavioral and environmental factors. Most individuals with this disease are overweight and therefore weight loss should be encouraged. Currently, the effects of intermittent fasting have been increasingly studied, not only in weight loss, but also in improving anthropometric, physiological and biochemical parameters in patients with diabetes. This approach involves alternating periods of partial fasting, where feeding is severely restricted, with periods of normal feeding. Intermittent fasting has been shown in humans to decrease the incidence of cardiovascular problems, diabetes, rheumatic diseases, chronic pain syndromes and metabolic syndrome. The objective of this study was to conduct a systematic review of available literature to evaluate if intermittent fasting is a viable short- and/or medium-term alternative for patients with type 2 diabetes mellitus and to assess if this approach has any kind of benefit compared to a continuous energy restriction. Material and Methods: A literature search was performed using the PubMed / MEDLINE database, with the keywords 'intermittent fasting' and 'type 2 diabetes' searched together. Both randomized and non-randomized trials were selected. The search was completed by the analysis of some bibliographical references of the selected articles. Results: A total of 7 articles were selected to address the effect of intermittent fasting in patients with type 2 diabetes mellitus. In most studies, intermittent fasting showed improvements in body weight, abdominal circumference, fasting glucose levels, insulin resistance, glicated hemoglobin, systolic and diastolic blood pressure, metabolic profile and quality of life. However, other articles did not reach the same conclusions, showing no significant improvements in glycated hemoglobin, insulin or insulin resistance index. Discussion: Intermittent fasting showed numerous benefits and, compared to continuous energy restriction, this proved to be a very effective alternative. However, there were several limitations, namely, reduced samples, unequal distribution by sex and the fact that some of the values were self-reported. It has also been shown that changes in hypoglycemic medication should be made depending on the number of days of fasting and the characteristics of the individuals. Conclusions: The literature on the subject is still scarce and there are no studies evaluating the effects of this approach in the long term. In spite of this, in the short and medium term it proved to be an alternative for those patients who cannot make a continuous caloric restriction, without showing a greater amount of episodes of hypoglycemia.

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Keywords

Jejum Intermitente, Endocrinologia, Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina, Nutrição, Diabetes Mellitus Tipo 2, Restrição Energética Contínua

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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