Type 2 Diabetes: Can You Reverse It?

Medically Reviewed By Kelly Wood, MD
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It is possible to reverse type 2 diabetes. Reversing diabetes means putting it into remission by achieving and maintaining normal blood sugar levels without medication. Reversing type 2 diabetes does not mean curing it. There is no cure for insulin resistance, the underlying cause of type 2 diabetes. The main way to reverse type 2 diabetes is through dietary changes, physical activity, and weight loss.

The best time to try to reach this goal is as soon as possible after getting a diabetes diagnosis.

This article explains what happens with type 2 diabetes, strategies to reverse type 2 diabetes, and how long it might take.

What happens in type 2 diabetes?

Type 2 diabetes is a metabolic disorder. It starts with insulin resistance. Insulin is a hormone that the body’s cells use to absorb glucose — a form of sugar — to use for energy.

In a body that is insulin resistant, the cells do not respond to insulin properly. Glucose builds up in the blood because the cells are not able to use it. The body reacts by telling the pancreas to make more insulin.

At some point, the pancreas cannot continue to meet the demand for insulin. Sustained high blood glucose levels can lead to complications, such as nerve damage, heart disease, and kidney problems.

Scientists who study diabetes believe that obesity is the main cause of insulin resistance. This is especially true for people who carry excess weight in the abdomen.

So, it makes sense that losing weight will have a positive effect on reversing insulin resistance. Studies have looked at this very issue. Their results suggest that weight loss is the solution to putting type 2 diabetes into remission.

How do doctors define remission?

Doctors define diabetes remission as having the blood glucose marker and fasting blood glucose level within the nondiabetic range. They must remain in this range for at least 6 months without the use of medicines. 

The main blood glucose marker is hemoglobin A1C. Achieving a hemoglobin A1C of less than 6.5% without needing medicine would meet the definition of remission. 

Likewise, having a fasting blood glucose level under 126 milligrams per deciliter would be in the nondiabetic range.

How can you reverse type 2 diabetes?

Losing weight is the most important step to take to reverse type 2 diabetes. Losing around 7–10% of your body weight can help your cells respond better to insulin. To induce remission, you must sustain this weight loss long term. 

For most people, lifestyle changes, physical activity, and a low calorie diet are the way to go. For those who meet the criteria, bariatric surgery is also an option. Many studies demonstrate how bariatric surgery can reverse type 2 diabetes. Talk with your doctor to establish a care plan and goals that are healthy for you.

The sections below discuss ways to help reverse type 2 diabetes.

Low calorie diet

Studies looking at low calorie diets to reverse type 2 diabetes usually involve a daily intake of about 900 calories. It is important to talk with your doctor before making this kind of change to your diet. Some people should only undertake this low calorie diet with medical supervision. 

A nutritious diet will be most successful when you find ways to stay with it for a lifetime. Strict diets that eliminate foods can be hard to sustain. Instead, you are more likely to succeed when you learn how to enjoy foods in the right quantity. 

Read more about different types of diet plans for diabetes.

Physical activity

Adding physical activity to dietary changes can help you achieve weight loss. To lose weight, you need to expend more energy than you take in. Burning calories through exercise can help promote weight loss.

As with dietary changes, talk with your doctor before starting an exercise program. You may need to start with short periods of moderate activity and progress in time and intensity.

Read more about exercise and diabetes.

Fasting

Therapeutic fasting may help some people lose weight and reverse type 2 diabetes. This type of fasting involves abstaining from caloric intake of any kind for a certain period of time. During a fasting period, you can have water and other low or no calorie drinks.

Fasting periods vary from most of a day to several days. Between fasting periods, it is important to eat healthy foods. Often, this involves diets low in sugar and carbohydrates.

A few case studies report success with this approach. Contact your doctor to discuss if it could be an option for you and how to implement it. 

Talk with your doctor before starting any fasting regimen. This is especially important if you are treating your diabetes with medications. You may be at risk of hypoglycemia.

Learn more about intermittent fasting for weight loss.

Bariatric surgery

Bariatric surgery is another name for weight loss surgery, such as gastric bypass. This surgery treats obesity by reducing the size of the stomach or altering the normal digestive process.

Research suggests that it can induce remission of type 2 diabetes. Type 2 diabetes reversal often starts before any significant weight loss occurs. This is likely due to hormonal changes that improve glucose use in the body. 

How long does it take to reverse type 2 diabetes?

How quickly you can reverse type 2 diabetes depends on several factors. The first is the method of weight loss. As mentioned above, remission can begin very quickly after bariatric surgery in some cases.

If you are aiming for remission through diet and exercise, it can take some time. The challenge is maintaining and sustaining lifestyle changes.

Along with significant weight loss, two factors that can make remission more likely are your baseline pancreatic function and diabetes duration.

Because type 2 diabetes is a progressive condition, pancreatic function will decline with time. Therefore, it may be easier to achieve remission when you start early. The longer you have type 2 diabetes, the harder it may be to achieve remission.

Summary

It is possible to reverse type 2 diabetes. The best opportunity to achieve remission is soon after your diagnosis. Even if you are not able to put the condition into remission, losing a significant amount of weight can give you better glucose control. High glucose levels contribute to serious complications.

A healthy meal plan and staying active are important for managing glucose levels, avoiding complications, and staying healthy when living with diabetes.

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Medical Reviewer: Kelly Wood, MD
Last Review Date: 2022 Jan 27
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