Reversing diabetes is a term that usually refers to a significant long-term improvement in insulin sensitivity in people with type 2 diabetes. 

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People with type 2 diabetes that are able to get their HbA1c  the below 42 mmol/mol (6%) without taking diabetes medication are said to have reversed or resolved their diabetes. This also known as putting diabetes into remission.

Loss of body weight can be particularly beneficial in helping to reverse the progression of diabetes.

With time and dedication, type 2 diabetes can be reversed and the results can be very rewarding, with less tiredness and better all-round health.

If you think you need to come off your diabetes medication, ensure you speak to your healthcare team before doing so.

 

Understanding how diabetes progresses

The most common cause of type 2 diabetes is obesity-related, which generally follows a vicious cycle pattern:

• Diet high in calories -particularly if high in refined carbohydrates.

• Insulin levels in the bloodstream rise to cope with the high- and quick-acting carb intake.

• Weight is gained around the belly (central or truncal obesity).

• Consistently high insulin levels lead to the body’s cells becoming resistant to insulin and commonly lead to weight gain.

• High insulin levels also increase weight gain.

• Insulin resistance leads to an increase in blood sugar levels, particularly after meals.

• The pancreas produces more insulin to cope with rising blood sugar levels.

• High sugar levels lead to feelings of lethargy and high insulin levels lead to increased hunger.

• Hunger often leads to overeating and lethargy, with less physical activity being taken.

• Overeating, less activity and high insulin levels all lead to further weight gain and more insulin resistance.

• Consistently high demand on the pancreas to produce extra insulin leads to damage of the pancreas’ insulin-producing beta cells.

• Beta cell damage results in the body struggling to produce enough insulin, and steeper rises in blood sugar levels leads to more recognisable symptoms of diabetes, symptoms of diabetes, such as thirst and a frequent need to urinate

 

Breaking the progressive cycle of type 2 diabetes

To reverse diabetes, you need to be able to break this cycle by taking the strain off your insulin-producing cells.

Research indicates that effective ways to reverse diabetes include:

• Low-carbohydrate diets

• Very low-calorie diets

• Exercise

• Bariatric surgery

 

Low-carbohydrate diets

Low-carbohydrate diets are known for lowering the amount of insulin the body needs to produce, resulting in less insulin resistance. [

A study published in 2014 by the Second University of Naples showed that a low-carbohydrate Mediterranean diet was able to achieve significant rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, 5% had achieved remission on the diet – a stunning achievement.

By comparison, low-fat diets were not as effective in the study. After one year, 4% of participants on a low-fat diet had achieved remission and, after six years, 0% of participants had achieved remission.

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Very low-calorie diets

Very-low-calorie diets (VLCD) have been shown to achieve significant weight loss, reduce insulin resistance and allow people with type 2 diabetes to come off their diabetes medication.

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In 2011, a study was published by researchers at Newcastle University showing that an 8-week 800 kcal per day diet was able to achieve remission from diabetes in seven of the 11 participants that took part. The diet included around 600 kcal from meal shakes and around a further 200 kcal from non-starchy vegetables. 

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The trial used MRI scans and showed that the reversal of diabetes appeared to be correlated with significant reductions in fat storage within the liver and pancreas.

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Currently, Newcastle University are running a study involving 32 participants. The participants were put on a similar diet for a similar length of time and then followed a low-calorie weight maintenance diet.

The participants will be reviewed for at least two years to see how many of the participants can maintain diabetes remission over this period.

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Initial results show that 40% of participants had achieved and maintained remission from type 2 diabetes six months after completing the diet.

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A VLCD is regarded as an extreme form of diet and therefore should be undertaken with care. If you are interested in following a VLCD, it is important that you first speak with your doctor to ensure the diet is safe for you to follow.

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In addition to the results seen in clinical trials, a number of anecdotal reports from patients show VLCDs to be successful at reversing diabetes to varying degrees. 

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