By Alison Sherwood
Medically Reviewed by Michael Dansinger, MD
Although there’s no cure for type 2 diabetes, studies show it’s possible for some people to reverse it. Through diet changes and weight loss, you may be able to reach and hold normal blood sugar levels without medication.
So how can you reverse diabetes? The key seems to be weight loss. Not only can shedding pounds help you manage your diabetes, sometimes losing enough weight could help you live diabetes-free — especially if you’ve only had the disease for a few years and haven’t needed insulin.
Several studies in England have looked at the effects of a very low-calorie diet on diabetes. Two had people follow a mostly liquid diet of 625-850 calories a day for 2-5 months, followed by a less restricted diet designed to help them keep off the weight they lost. Both studies found that nearly half the people who took part reversed their diabetes and kept their blood glucose near the normal range for at least 6 months to a year.
When you have type 2 diabetes, cells that help your body control your blood sugar stop working right. Doctors used to think they were shut down for good, but research shows that certain cells may come back. People who lost weight had lower levels of fat in their liver and pancreas, and for some of them, that helped the beta cells in their pancreas that release insulin and control blood sugar start working again.
The odds of rescuing those cells are best early on. That suggests it may be better for doctors to help people lose a lot of weight after a diagnosis, rather than make small lifestyle changes and manage symptoms with medication.
More physical activity is a way to improve diabetes, but it may be tough to lose enough weight to go into remission with workouts alone. When combined with changes to your eating, though, exercise helps. A modest, lower-calorie diet plus a big step-up in burning calories could put you on the path to remission.
A study that had people aim for 10,000 steps a day and at least 2 1/2 hours of moderate exercise a week — along with cutting 500-750 calories a day and following specific insulin and medication routine — saw more than half of them reach near-normal blood sugar without medication. Some were able to keep those levels long-term, too.
The bottom line: It’s the weight loss that really matters. Exercise can help you get there but expect to change your diet as well.
Mayo Clinic: “Type 2 diabetes: Diagnosis & treatment,” “Bariatric surgery.”
World Journal of Diabetes: “Reversibility of diabetes mellitus: Narrative review of the evidence.”
Diabetes Care: “Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders,” “How Do We Define Cure of Diabetes?” “Incidence of Remission in Adults With Type 2 Diabetes: The Diabetes & Aging Study,” “Bariatric Surgery for Type 2 Diabetes Reversal: The Risks,” “Type 2 Diabetes Remission Rates After Laparoscopic Gastric Bypass and Gastric Banding: Results of the Longitudinal Assessment of Bariatric Surgery Study.”
The Lancet: “Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomized trial.”
Cell Metabolism: “Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery.”
Annals of Internal Medicine: “Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial.”
Georgian Medical News: “Clinical Case of Type 2 Diabetes Remission.”
Journal of Clinical Endocrinology & Metabolism: “Piloting a Remission Strategy in Type 2 Diabetes: Results of a Randomized Controlled Trial.”
Cleveland Clinic Journal of Medicine: “Bariatric surgery for type 2 diabetes: Weighing the impact for obese patients.”
Journal of Laparoendoscopic and Advanced Surgical Techniques Part A: “Obese Patients with Type 2 Diabetes: Outcomes After Laparoscopic Sleeve Gastrectomy.”
Annals of Surgery: “Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus.”
BMJ: “Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin.”
JAMA Network Open: “Effect of Intermittent Compared With Continuous Energy Restricted Diet on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Noninferiority Trial.”
FDA: “Beware of Illegally Marketed Diabetes Treatments.”
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