Simple ways to reverse diabetes
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Diabetes has become an epidemic, with an estimated 5.8 million people in the UK living with diabetes and rates are rising. Data from Diabetes UK shows that almost 4.6 million people in the UK live with a diabetes diagnosis. Additionally, nearly 1.3 million people could be living with type 2 diabetes who are yet to be diagnosed. Despite its significant impact on the population, there remains no cure for this condition. Most treatments help patients manage the symptoms to a certain extent, but people with diabetes can still face multiple long-term health complications.
There is hope in the form of type 2 diabetes reversal (known in medical terms as ‘remission’), in which long-term lifestyle changes can bring blood sugar levels back within a healthy range. Read on to find out more about reversing diabetes with diet, exercise and weight loss medication.
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What does it mean to reverse type 2 diabetes or put it into remission?
Type 2 diabetes remission occurs when your blood sugar levels return to a safe, non-diabetic level on a long-term basis, without the need for glucose-lowering medication. It stops diabetes in its tracks and boosts your chances of a healthy future.
In clinical terms, remission is defined as when your HbA1c, a measure of blood glucose level, remains below 48 mmol/mol or 6.5% for at least three months, without the use of diabetes medication.
Dr Rupa Parmar, medical director and private GP at Midland Health, says. ‘While there’s no definite ‘cure’ for type 2 diabetes, remission is possible for some people. This means their blood sugar levels return to a healthy range without the need for medication. However, remission isn’t the same as a permanent cure, as diabetes can return.
‘Generally, people diagnosed earlier, particularly within the first few years and before needing insulin, have a better chance of remission. That’s because their pancreas’ beta cells, which produce insulin, are more likely to recover if action is taken early.’
Is type 1 diabetes reversible?
People with type 1 diabetes cannot reverse their diabetes or go into remission. There are treatments for managing it, but these treatments mainly focus on managing blood sugar levels, rather than reversing the underlying causes of type 1 diabetes. This is because the cause of type 1 diabetes is still unknown.
Benefits of type 2 diabetes remission
Being in remission and having blood sugar levels below the diabetes range long-term can reduce your chances of developing diabetes-related complications, including:
- Eye problems
- Diabetic foot problems are serious and can lead to amputation if untreated.
- Kidney problems
- Nerve damage
GP Dr Deepali Misra-Sharp says by bringing your blood sugars into a non-diabetes range long-term, the symptoms of diabetes and any new damage it can do to your body are on pause. ‘This doesn't mean your diabetes is ‘cured’ as your blood sugar levels can rise again. You still need to make sure you attend regular check-ups and get the support you need to treat or manage any existing diabetes-related complications. But it does mean that you are more likely to feel better and see improvements in your health long-term.’
Does weight loss reverse diabetes?
Arti Dhokia, consultant dietitian at Midland Health, says, ‘Weight loss is key for reversal, and this is usually done through intense diet changes, such as low-calorie diets under medical supervision. To achieve a calorie deficit, reducing high-calorie foods, such as those high in fat and sugar, is essential. Reducing large portions of carbohydrates, as these can cause spikes in blood sugar and insulin levels, increase hunger, and make the body more likely to store fat.’
What is the best diet for type 2 diabetes reversal?
The DIRECT study – one of the biggest research studies into type 2 remission showed that a low-calorie weight management programme offers most people living with type 2 diabetes the best chance of putting their diabetes into remission. But it’s not the only way you can lose weight quickly and safely. People have lost weight and put their type 2 diabetes into remission through different diets.
Registered dietitian Charlotte Foster says, ‘Just like your diabetes, weight loss is very individual. What works for one person might not work for another. Your current weight or BMI and the level of changes you’re able to make are just some of the things people tell us they think about when choosing a diet. It’s important you speak with your healthcare team before making changes to your eating habits, as not all diets are safe or right for everyone.’
Some of the diets recommended for type 2 diabetes remission include:
- A low-calorie diet: which typically involves consuming around 800-1200 calories per day. Low-calorie diets work by limiting the number of calories you consume, so your body doesn't take in more calories than it needs to use.
- Intermittent fasting: In which you eat all of your daily meals within a restrictive window and fast for the rest of the day. Fasting can help people to lose weight because they tend to consume fewer calories during the eating hours than they do when they eat at any time of the day.
- A low-carb diet: Following a low-carb diet means eating less than 130g of carbohydrates a day. Research has shown that a low-carb diet can improve blood sugar control, lead to weight loss, and decrease the risk of cardiovascular issues.
- Mediterranean diet: Evidence suggests that following a Mediterranean diet, which involves eating lots of fresh food, rather than processed food high in unhealthy saturated fat, can help weight loss and lower blood sugar levels in people with type 2 diabetes. Some people who have followed a Mediterranean diet have lost weight and gone into type 2 diabetes remission.
- Meal replacement diet: A short-term weight loss plan where you replace all or some of your meals with specially formulated food products. For most people, a total diet replacement programme can be followed for periods up to 12 weeks. In some areas of the UK, the NHS offers meal replacement plans as part of type 2 diabetes support programmes.
Should I stop drinking alcohol to reverse diabetes?
Dhokia says limiting or giving up alcohol plays a vital role in reversing type 2 diabetes. ‘After all, alcohol is high in calories, making weight loss much harder. Plus, it impairs the liver’s ability to regulate blood sugar and increases the risk of low blood sugar in diabetics, especially overnight. That’s why it's best to stay below the recommended 14 units a week, spreading your intake over several days.’
Exercise for type 2 diabetes remission
Exercise offers numerous benefits for your overall health and may also be a way to manage diabetes. As Dhokia says, ‘Moving more can help you lower your blood sugar levels long term. This is because when your muscles move, they use up sugar, also known as glucose, in the blood, bringing your blood sugar levels down.’
Moving more can also:
- help you lose weight if you need to, and keep the weight off
- give you energy and help you sleep
- help your joints and flexibility
- help your mind as well as your body – exercise releases endorphins, which you may know as ‘happy hormones’
- help your blood pressure, which can put you more at risk of diabetes complications
- help to improve cholesterol (blood fats) to help protect against problems like heart disease
But Dhokia warns against using exercise alone to try to reverse diabetes: ‘There’s no evidence that exercise alone can lower blood sugar levels enough to put type 2 diabetes into remission. Making the necessary changes to your diet that are proven to do that. We also know that exercise helps people maintain their weight loss, which is important for staying in remission.’
GLP-1 medication for diabetes reversal
One of the most significant developments in type 2 diabetes treatment has been the emergence of glucagon-like peptide 1 (GLP-1) receptor agonists, which can be prescribed to lower blood sugar levels in individuals with type 2 diabetes, according to Dr Misra-Sharp. They can also be prescribed to support some people with weight loss.
She explains, ‘This medication works by increasing the levels of incretins – hormones – which help the body produce more insulin when needed and lower blood sugar levels. Some people lose weight when they take a GLP-1 agonist as part of their type 2 diabetes treatment. This is because these drugs slow down how quickly food is digested and can reduce your appetite, so you eat less.’
Some GLP-1 agonists can be prescribed to help with weight loss:
- Mounjaro can be used to treat type 2 diabetes, and it is being rolled out as a medication for weight loss on the NHS.
- Saxenda, the brand name for liraglutide, can be prescribed to people living with type 2 diabetes or prediabetes as an option for weight management.
- Wegovy, a brand name for semaglutide, can be prescribed to people living with type 2 diabetes or prediabetes as an option for weight management.
Dr Misra-Sharp advises proceeding with caution if you believe these injections are a miracle cure. ‘There is some evidence that people can put weight back on when they stop using weight loss drugs. This means that it’s essential to receive support in making changes to your diet and physical activity levels to maintain the weight you’ve lost. Maintaining weight loss is especially important for staying in remission.’
While these medications are available through private clinics, the healthcare professional prescribing your medication must be aware of your complete medical history, including the type of diabetes, and your accurate body weight.
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