Can You Reverse Type 2 Diabetes? What The Research Says

Diabetes remission is possible. Discover how diabetes patients can live without medications.

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by
Merve Ceylan
— Signos
Health Writer & Dietitian
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Reviewed by

Merve Ceylan
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Updated by

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Science-based and reviewed

Published:
February 14, 2024
December 7, 2023
— Updated:

Table of Contents

Diabetes mellitus is a chronic disease caused by absent or inefficient insulin production, which results in increased blood glucose levels and health problems. There is no cure to reverse diabetes yet. Currently, the goal of diabetes treatment is to prevent symptoms and stay in remission. 

A recognized definition of diabetes remission is hemoglobin A1c (HbA1c) levels being less than 6.5 % without the help of medication. Several approaches, including medication and lifestyle interventions, have been examined for diabetes remission. In this article, you'll learn about interventions that can potentially lead to diabetes remission. 

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Differences Between Type 1 and 2 Diabetes

This difference stems from the pathophysiology of type 1 and type 2 diabetes. In type 1 diabetes patients, insulin is not produced. While in type 2 diabetes, insulin is produced but does not function properly or not in enough quantities. 

Pancreatic beta cells are the cells that produce insulin, which is a hormone needed for glucose to enter cells. In type 1 diabetes, immune cells attack pancreatic beta cells and destroy their ability to produce insulin. So, type 1 diabetes patients must take insulin to regulate blood glucose levels. On the other hand, type 2 diabetes is manageable without medication for some patients.

The type of diabetes a patient has changes the direction of treatments and interventions and the effects of those. While complete remission is possible for both type 1 and type 2 diabetes, it's exceptionally rare in type 1 diabetes patients.

According to the definition by the consensus expert groups from Diabetes UK, the American Diabetes Association, and the European Association for the Study of Diabetes, diabetes remission is achieved if HbA1c levels are below 6.5 % for at least three months without diabetes medication. You should consult your doctor about diabetes remission if your HbA1c is below 6.5 % for three months at minimum.  

7 Ways to Diabetes Remission 

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Patients living with type 2 diabetes have been shown to achieve remission for long periods, 25 years being reported. Remission can help patients live medication-free with the annual health checks. Let's look at seven ways that can possibly help diabetes remission. 

Focus On Weight Loss

Weight loss can improve pancreas function, leading to insulin secretion and increased insulin efficacy.

Weight loss is one of the most effective methods to achieve type 2 diabetes remission. At least 10 to 15 kg (22 to 33 pounds) of weight loss has been associated with decreased blood glucose levels below the diabetic range. The results of the Diabetes Remission Clinical Trial (DiRECT) showed that 46% of patients living with diabetes for up to six years achieved remission following a weight management program for a year. Eighty-six percent of participants who lost 15 kg or more body weight achieved remission in a year. 

Several methods have been addressed for weight loss in diabetes patients, including short-term low-calorie diets, carbohydrate restriction, calorie restriction, lifestyle changes, and bariatric surgery. 

Carbohydrate Restriction

Low carbohydrate diets are associated with improved blood sugar levels and weight loss. Various degrees of carbohydrate restrictions have been described in research. Less than 130 g/day of carbohydrates is considered a low-carbohydrate diet. A meta-analysis of 23 randomized clinical trials showed that diets with 130 g/day or less carbohydrates for six months result in higher diabetes remission rates. 

Caloric Restriction

Caloric restrictions, especially low-calorie diets, are used to achieve rapid weight loss. A diet containing 800 to 1200 calories is generally considered a low-calorie diet. Short-term low-calorie diets have been associated with improved pancreatic beta cell function, fasting glucose, and hepatic insulin sensitivity.  

Following a Structured, Healthy, and Balanced Diet 

Obesity is a major risk for developing diabetes, so many patients struggle with weight gain. A healthy and balanced diet is essential to keep a healthy range of blood sugar levels and body weight. 

Structured nutrition plans for individual goals, such as achieving weight loss or maintaining remission, help patients' blood sugar levels stay below diabetic ranges. You can consult your doctor and dietitian to get a personalized nutrition plan.

Physical Activity

Maintaining a healthy weight after weight loss can help stay in remission. Sustained moderate activity can be valuable to maintain achieved weight loss. 

Diabetes patients are encouraged to exercise for better glucose management and health. The Centers for Disease Control and Prevention (CDC) recommends 150 minutes of moderate-intensity physical activity in addition to at least two days of strength training. 

Surgical Intervention (Bariatric Surgery)

Bariatric surgeries involve operations to alter the digestive system for weight loss. Although the outcome of all surgeries is weight loss, the methods are different. The types of bariatric surgeries include sleeve gastrectomy, Roux-en-Y gastric bypass, and laparoscopic adjustable gastric banding. 

National Institutes of Health (NIH) standards approve the eligibility of type 2 diabetes patients above 35 kg/m2 BMI for bariatric surgery. Several meta-analyses showed beneficial effects of bariatric surgery in reducing BMI, blood glucose markers including fasting blood glucose and Hb1Ac, and diabetes remission.  

Medication

Diabetes remission requires the withdrawal of diabetes medication. However, medication can be helpful in the process of achieving diabetes remission. Short-term intensive insulin therapy can improve beta-cell function and decrease insulin resistance

Intermittent Fasting

Intermittent fasting covers many types of periodic eating, including alternate-day fasting, 5:2 fasting, 24-hour fasting, daily time-restricted fasting, and so on. The evidence showing the effects of intermittent fasting for diabetes remission is scarce. 

A 2023 randomized controlled study investigated the effects of intermittent fasting in remission. Participants were patients 1 to 11 years from type 2 diabetes diagnosis. They were administered a type of intermittent fasting involving five days of fasting and ten days of reintroducing everyday foods. The fasting group consumes 840 calories on fasting days. The cycle repeated six times over three months. After three months of follow-up, at six months, the results showed that in the fasting group, more patients significantly achieved remission than the control group. Although the results are promising, further evidence is needed to understand the effects of fasting on diabetes and diabetes remission. 

<p class="pro-tip"><strong>Learn more: </strong> <a href="/blog/milk-diabetes">Milk and Diabetes: Nutrition, Benefits, and Best Options</a>.</p>

Avoid These When Looking To Reverse Diabetes

Remission is achieved if a patient has blood glucose levels below the diabetic range for an extended period, at least three months. Therefore, while interventions to maintain target blood glucose levels can help to achieve remission, unsupervised interventions can hinder the process of remission. 

Illegally Marketed Products

There are companies illegally selling products claiming that they treat, cure, or prevent diabetes. It's important to acknowledge that no product can be a substitute for your diabetes medication. Using products as replacements for diabetes medications can cause serious complications. 

Over-The-Counter Drugs

Over-the-counter drugs can be bought without a prescription for various reasons, including easing colds, relieving pain, and managing some health problems such as allergies and migraines. However, diabetes patients should be more careful about unsupervised drug use since other drugs can interact with diabetes medication.  

Homeopathic Products

Be aware that there is no FDA-approved product labeled as homeopathic. If you see any products claiming "homeopathic" on their label, they're marketed without FDA regulation, so there is no information about their safety and effectiveness.  

Hidden Ingredients in "All Natural" Claims

Products claiming to be "all-natural" or "100% natural" can contain harmful hidden ingredients. Even if the claim is correct, a product being natural is not a guarantee for its safety. Always get your doctor's approval before using any products. 

Dietary Supplements 

Some dietary supplements have been shown to exert beneficial effects on blood glucose levels and diabetes symptoms. Keep in mind that dietary supplements can also cause side effects. Therefore, consult your healthcare provider to learn if your supplements interact with your medication. 

Fad Diets

Fad diets are diets that promise quick fixes for weight loss and health. They generally hype or eliminate specific food groups, promote unbalanced eating patterns, mandate supplements, promote absurd eating patterns, and so on. 

Some patients tend to follow a fad diet to "quickly" lose weight. Although weight loss is great for improving diabetes, it should be achieved through methods that are not harmful to health. Fad diets can cause fluctuations in blood glucose levels, leading to hypoglycemia, which is not only dangerous but also negatively affects the process of remission. 

Following Any Interventions Without Your Doctor's Approval

Patients often hear bits of advice from others; however, trying any intervention that could be related to diet or products can be dangerous. If you want more information about specific interventions, always consult your doctor. 

Frequently Asked Questions

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Remission has been talked about more than ever, with accumulating evidence showing diabetes patients can live without the need for medication. Therefore, there are many questions about remission. Let's look at some of them. 

Can Type 2 Diabetes Go Away? 

There is no cure for type 2 diabetes yet; however, remission of type 2 diabetes is possible. Research suggests that remission can be achieved mainly by weight loss and maintaining a healthy, balanced diet and active lifestyle. 

Are Stem Cells a Possible Cure for Diabetes?

The potential of stem cell therapies is being tested in clinical trials in type 1 diabetes patients. As research suggests, stem cell therapy can be life-saving for people with diabetes, especially those who have frequent hypoglycemia and can't tell the signs of hypoglycemia when it occurs, which can cause emergencies. 

Currently, stem cells are predominantly researched for type 1 diabetes patients. In the future, stem cell therapies are hoped to be used to increase functional beta cell availability in type 2 diabetes patients. 

How Long Will Diabetes Stay In Remission?

Type 2 diabetes patients can stay in remission for a long time; 15 years of remission have been reported. However, be aware that blood glucose levels start rising again. Therefore, it's crucial to have regular health checks when in remission. 

What Are The Benefits of Remission? 

In remission, blood glucose levels stay below the diabetes range, which can lower the risk of complications. Also, losing weight and maintaining extended remission can support metabolic and cardiovascular health by improving blood pressure and cholesterol levels. Be aware that remission does not guarantee that any complications will not occur, so don't neglect the regular health check. 

Is Remission Possible for Patients With a Longer Diabetes Duration? 

Yes, remission is possible a long time after being diagnosed with type 2 diabetes, even after 25 years of diagnosis. However, it's less likely than a newly diagnosed patient who lost weight without delay. 

Learn How to Improve Your Nutrition and Monitor Your Glycemic Index Levels with Signos' Expert Advice

Signos' CGM, a continuous glucose monitoring system, provides continuous blood glucose data. The system measures your glucose levels in real-time. It utilizes the data to send alerts when blood glucose spikes and gives personalized recommendations for nutrition and exercise in addition to tracking sleep, hydration, nutrition, and exercise. 

Signos can improve your health by providing blood glucose levels throughout the day, which can help you and your healthcare professionals spot the dips and spikes in blood glucose levels. Then, the data can be used to optimize your nutrition and exercise for better glucose management. 

If you're curious about how Signos' CGM helps you, take a quick quiz and explore.

<p class="pro-tip"><strong>Keep reading: </strong> <a href="/blog/best-supplement-for-diabetes">10 Best Herbs and Supplements for Diabetes That May Help</a>.</p>

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References

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About the author

Merve Ceylan is a dietitian and health writer.

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