1. Identify the explanatory and response variables in yourstudy.

2. Explain why the study is an observational study or anexperiment.

3. Can we conclude that there is a causal relationship betweenthe explanatory and response variables?

This is the Study:https://www.sciencedaily.com/releases/2018/10/181009210738.htm

Planned intermittent fasting may help to reverse type 2diabetes, suggest doctors writing in the journal BMJ CaseReports after three patients in their care, who did this, wereable to cut out the need for insulin treatment altogether.

Around one in 10 people in the US and Canada have type 2diabetes, which is associated with other serious illness and earlydeath. It is thought to cost the US economy alone US$245 billion ayear.

Lifestyle changes are key to managing the disease, but bythemselves can't always control blood glucose levels, and whilebariatric surgery (a gastric band) is effective, it is not withoutrisk, say the authors. Drugs can manage the symptoms, and help tostave off complications, but can't stop the disease in its tracks,they add.

Three men, aged between 40 and 67, tried out plannedintermittent fasting to see if it might ease their symptoms. Theywere taking various drugs to control their disease as well as dailyunits of insulin. In addition to type 2 diabetes, they all had highblood pressure and high cholesterol.

Two of the men fasted on alternate days for a full 24 hours,while the third fasted for three days a week. On fast days theywere allowed to drink very low calorie drinks, such as tea/coffee,water or broth, and to eat one very low calorie meal in theevening.

Before embarking on their fasting regime, they all attended a6-hour long nutritional training seminar, which includedinformation on how diabetes develops and its impact on the body;insulin resistance; healthy eating; and how to manage diabetesthrough diet, including therapeutic fasting.

They stuck to this pattern for around 10 months after whichfasting blood glucose, average blood glucose (HbA1c), weight, andwaist circumference were re-measured.

All three men were able to stop injecting themselves withinsulin within a month of starting their fasting schedule. In onecase this took only five days.

Two of the men were able to stop taking all their other diabeticdrugs, while the third discontinued three out of the four drugs hewas taking. They all lost weight (by 10-18%) as well as reducingtheir fasting and average blood glucose readings, which may helplower the risk of future complications, say the authors.

Feedback was positive, with all three men managing to stick totheir dietary schedule without too much difficulty.

This is an observational study, and refers to just threecases-all in men. As such, it isn't possible to draw firmconclusions about the wider success or otherwise of this approachfor treating type 2 diabetes.

"The use of a therapeutic fasting regimen for treatment of [type2 diabetes] is virtually unheard of," write the authors. "Thispresent case series showed that 24-hour fasting regimens cansignificantly reverse or eliminate the need for diabeticmedication," they conclude.