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By Chinenye Anuforo
Healthcare experts have called for personalised diabetes care for adolescents who choose to observe intermittent fasting, warning that doing so without proper medical supervision could expose them to serious health complications.
The recommendation follows a narrative review by Blessing Edidiong Dickson, a nursing student at Washtenaw Community College, Michigan, United States, titled “Diabetes Management Challenges During Intermittent Fasting Among Adolescents: A Narrative Review of Recent Evidence.”
The review examined more than a decade of scientific evidence on the impact of fasting—driven by religious, cultural and lifestyle practices—on diabetes management among adolescents.
According to Dickson, the findings indicate that intermittent fasting can significantly increase the risk of hypoglycaemia, hyperglycaemia, ketosis, dehydration and psychological stress among young people living with diabetes.
She noted that adolescents receiving insulin therapy, particularly those with Type 1 diabetes, are especially vulnerable because prolonged fasting can quickly disrupt metabolic balance.
“Our review found that intermittent fasting presents significant clinical challenges for adolescents living with diabetes, particularly those treated with insulin,” she said.
“The evidence highlights the need for careful risk assessment, individualised treatment plans and close monitoring before adolescents undertake fasting.”
Dickson explained that social, cultural and psychological factors also influence adolescents’ decisions to fast, with peer pressure, social media trends and religious expectations often encouraging the practice without adequate medical guidance.
She added that limited access to continuous glucose monitoring technology and inconsistent clinical recommendations further complicate diabetes management in many communities.
“Many adolescents choose to fast because of social, cultural or religious expectations, sometimes without understanding the potential health consequences,” she said.
“This makes collaboration among healthcare providers, families and patients essential to ensure fasting decisions are made safely.”
The researcher observed that most existing clinical guidelines on fasting and diabetes are based on studies involving adults, leaving significant gaps in evidence for adolescents.
She therefore called for more adolescent-specific research to support the development of age-appropriate clinical guidelines.
Dickson recommended comprehensive pre-fasting health assessments, personalised medication adjustments, structured glucose monitoring and shared decision-making involving healthcare providers, caregivers and adolescents.
According to her, these measures can reduce preventable complications while respecting patients’ cultural and religious beliefs.
She said the review contributes to ongoing efforts to strengthen evidence-based diabetes care for adolescents and underscores the need to integrate developmental, cultural and health system considerations into chronic disease management.
The study, she added, forms part of broader interdisciplinary research aimed at improving health outcomes for adolescents living with diabetes while addressing the unique challenges associated with intermittent fasting.
