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If you have been overweight or obese for a long time, if you suffer from PCOS (polycystic ovary syndrome), if you are prediabetic, or if you have type 2 diabetes. If this describes you, then it is likely that your body is severely insulin resistant (and if you have been diagnosed as prediabetic or with type 2 diabetes, then this is definitely going to be true for you). The key is going to be getting your insulin down over time so your body can heal. While fasting is wonderful for lowering insulin levels, you may also need a more structured dietary approach to lower insulin even more. Remember that we need to have lower levels of circulating insulin to tap into our fat stores for fuel during the fast. This is where a low-carb or keto plan can make a positive difference. You may not have to follow a lower-carb plan forever; a combination of low-carb eating and intermittent fasting can reverse your insulin resistance over time, and you may find that you can tolerate more carbs as time goes on and your body heals.
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Gin Stephens (Fast. Feast. Repeat.: The Comprehensive Guide to Delay, Don't Deny® Intermittent Fasting--Including the 28-Day FAST Start)