EFFECT OF UPAVASA (INTERMITTENT FASTING) IN CORRECTING BLOOD SUGAR LEVELS IN INSULIN-RESISTANT SUBJECTS: A COMPREHENSIVE REVIEW
Introduction: Insulin resistance is a pivotal pathological feature underlying type 2 diabetes mellitus (T2DM) and metabolic syndrome. Upavasa, a therapeutic fasting modality described in classical Ayurvedic texts as one of ten Langhana (depletion) therapies, shares conceptual and physiological parallels with modern intermittent fasting (IF). This review evaluates the effect of Upavasa and IF on correcting blood sugar levels and improving insulin sensitivity in insulin-resistant subjects.
Methods: A comprehensive literature search was conducted across PubMed, Scopus, Google Scholar, Cochrane Library, and AYUSH Research Portal for studies published between 2005 and 2025. Classical Ayurvedic texts were consulted for traditional context. Randomised controlled trials, systematic reviews, and meta-analyses investigating intermittent fasting effects on fasting blood glucose (FBG), HbA1c, HOMA-IR, and fasting insulin in insulin-resistant or T2DM subjects were included.
Results: Multiple meta-analyses demonstrated that IF significantly reduced FBG (SMD = −0.51; p = 0.001), fasting insulin (SMD = −0.21; p = 0.030), HOMA-IR (SMD = −0.39; p = 0.004), and HbA1c (SMD = −0.25; p = 0.034) compared to controls. Key molecular mechanisms included AMPK activation, mTOR suppression, enhanced autophagy, improved insulin signalling, and reduction of pro-inflammatory cytokines.
Discussion: The convergence of Ayurvedic Upavasa principles with modern IF evidence supports structured fasting for glycaemic correction in insulin-resistant subjects. However, standardised clinical protocols, long-term safety data, and Prakriti-based personalisation warrant further investigation through well-designed clinical trials.