Can Type 2 Diabetes Be Reversed?

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Type 2 diabetes (which used to be called adult-onset or non-insulin-dependent diabetes) can be a life-long, chronic disease in which the body either does not produce enough insulin or the cells don’t respond to the insulin correctly. Because of these two problems, there isn’t enough insulin to move the glucose from the blood into the cells. When glucose builds up in the blood instead of going into cells, the body’s cells can’t function properly.

Type 2 diabetes is more likely to occur in people who are over the age of 40, overweight, or have a family history in diabetes. However, more and more younger people, including adolescents, are developing type 2 diabetes.

According to recent research, type 2 diabetes cannot be cured, but it can go into remission or at least partial remission. Remission means that the symptoms of the disease abate for a period of time.  The primary means by which people with type 2 diabetes achieve remission is by losing significant amounts of weight.

We talk of remission and not a cure because it isn’t permanent.  The beta cells have been damaged and the underlying genetic factors contributing to the person’s susceptibility to diabetes remain intact. Over time the disease process reasserts itself and continued destruction of the beta cells ensues. An environmental insult such as weight gain can bring back the symptomatic glucose intolerance.

Donna Younger, MD Joslin clinic physician says that this is a complicated topic.  “Obese individuals  with type 2 diabetes are usually very insulin resistant. When they lose weight their bodies often have sufficient insulin available to maintain blood glucose in the normal range if they continue to follow a healthy diet and exercise regularly. There are some people who can deviate from dietary modifications and continue to achieve euglycemia, but this is much rarer.”

Patients may also go into remission when prior to treatment they were glucose toxic.  Glucose toxicity can temporarily shut down insulin production from the beta cell. When this is relieved the beta cells begin to function again. This is seen in patients who have had untreated diabetes for a long time and whose A1C are severely elevated. They may require insulin for a short period of time and then can often revert to pills or lifestyle control.

Although remission can be achieved by standard medical means of lifestyle manipulation, many remissions are a consequence of gastric bypass surgery. These patients often experience complete, albeit temporary, (it can be for years) reversal of hyperglycemia.  It is the change in hormonal milieu driven by the surgery that leads to improved glucose metabolism even before significant weight loss occurs.

However, having a gastric bypass is a drastic step to take and should only be considered by those whose BMI and medical complications put them at risk for serious health complications.

For most people behavior modification (initially with or without medications) can help bring type 2 diabetes into excellent control.

Excess weight increases insulin resistance, so by shedding just 7 to 10 percent of your bodyweight, your cells will be better able to respond to the insulin your body makes.

The key to losing weight is finding a meal plan and a workout regimen that will best suite you and your lifestyle. The best meal plan is one that will teach you to make healthy food choices and control food portions that you can follow for a lifetime. Don’t worry -a meal plan isn’t a strict diet where you can no longer eat and enjoy your favorite foods-it’s all  about giving you guidance to shape your eating pattern.

Through these significant lifestyle changes you could be well on your way to controlling your diabetes. But this is certainly not the case for everyone with type 2 diabetes. Over time your blood glucose levels could start to increase even if you’re following your healthy meal plan and staying active—this is just part of the disease progression.

Don’t get discouraged, it is common for people to slip back into their old habits. Talking to a registered dietitian or diabetes educator, or even signing up for a refresher course on diabetes—like Joslin’s DO IT program—, can help you get motivated again.

If you have any questions about your diet, a registered dietitian is a good source of information. Make an appointment with one of Joslin’s certified diabetes educator dietitians by calling (617) 732-2440, or learn more by visiting

9 Responses to Can Type 2 Diabetes Be Reversed?

  1. Keith says:

    Yep, for me diet & exercise seems to do the trick for me.

  2. PI says:

    ” ……Over time your blood glucose levels could start to increase even if you’re following your healthy meal plan and staying active—this is just part of the disease progression.”

    Are you saying that this is BECAUSE people are slipping into old habits or is this happening regardless? What about people who do NOT slip?? Does the T2 disease still progress?

    • From Nora Saul, Manager of Nutrition Services:
      Dear PI,
      Unfortunately, the natural history of the disease is a slow, progressive decline in beta cell mass over time. However, healthy eating habits and exercise can extend this time frame.

      • Camilo says:

        Dear Nora,
        According to the last results from New Castle University lead by MD Roy Taylor, it is a progressive disease as long as you keep putting on weight.
        If it is indeed a progressive disease, how can a person who lived with diabetes for up to 28 years go into remission? How is it explained that the persons that went through bariatric surgery or low calory diet shows normal OGTT? The idea of a progressive disease has been overlooked.

  3. Victoria Mayes says:

    Nice to see this article about remission and would love to see stories about how long some people have been able to maintain remission as we are hopeful for very long term.

    My husband was diagnosed with type 2 just over 5 years ago at age 64. At the time, his fasting blood sugar was 155 and A1c was 6.4. With diet and exercise, his A1c was down to 5.6 and fasting glucose was 103 after 3 months. He has been able to maintain this for five years by maintaining weight at normal BMI (lost 45 lbs total) and keeping CHO consumption at around about 40% of calories along with regular exercise. A1c this week was 5.5.

  4. PI says:

    Nora – I was quite depressed when I read your answer – so I also would like more info from people who have successfully maintained their remission over a very long time. I am a 71yo F who has been low carbing and exercising since diagnosis in early 2010 and has maintained an HbAic of ~5.3. My usual FBG is ~4.7.

    I’m looking forward to seeing replies from people with many many years of remission.

  5. Pingback: News & Views | War On Diabetes

  6. Gary says:

    It may be true that DM can only be halted for a time, or slowed, and that lifestyle changes must be maintained indefinitely to avoid or minimize typical hyperglycemic damage to the body.

    However, whether in cancer, or DM, or any other chronic disease, gaining time is the name of the game. That time means a better quality of life for a longer period of time, and a chance for the smart guys to find a better treatment or even a cure. And make no mistake about it, the pharmaceutical company that finds the cure for DM will become wealthy enough to own the planet. You can bet your blood meter that they are burning aneles at both ends to be the first with a cure. And it seems to be a more more likely possibility than a cure for many other things.

    Hang in there, folks!

  7. Gigi Speaks says:

    I’m 2005 I was diagnosed with PCOS and “borderline” diabetes. I was told I needed Glucophage and several other prescriptions. Even with insurance I couldn’t afford the prescriptions at the time. A short time later I changed jobs and couldn’t afford the insurance provided and have not been able to afford it since so I remained untreated. I’m 2007 I started noticing dark patches of skin under my breasts and on my inner thighs-A sure sign of full blown diabetes. I also experienced the constant thirst and very very frequent urination. While not formally diagnosed I obviously was suffering from diabetes. Fast forward 10 years and I have been experiencing neuropathy in my feet for about 5 years now-getting worse and worse. I reached a point a few months ago where I literally felt my death was imminent. I mistakingly thought because I had no financial access to healthcare there was nothing I could do. Boy was I wrong! In desperation I get online and start researching. I started with the basics-good carbs no soda or candy etc. I lost 20lbs in a month and felt off to a good start. Then I started reading about ESSENTIAL OILS and their health benefits and I find that cinnamon oil LOWERS AND STABILIZES BLOOD SUGAR. Are you kidding me? It’s $9 for a bottle that will last a long time! I started soaking my feet for 20 minutes and then applying 4-5 drops of the cinnamon oil to the bottom of my feet every morning. I havent so much as walked across a street in the way of exercise since I started this change. Month one as I said I lost 20lbs just adjusting my dietary habits. Month 2 with the addition of the daily cinnamon oil I have lost an additional 15 lbs and I eat 5 times a day!! The dark skin patches ARE GONE. THE NEUROPATHY IS GONE! For the price of a bottle of oil. I also realized from my research that I have hypothyroid as well. I discovered my thyroid needed vitamin C and coconut oil so I began eating 10 strawberries a day and rubbing raw organic coconut oil directly on my throat for the thyroid to absorb-when I get up in the morning and before I go to bed. 6 weeks later the sluggishness is gone! The mood swings are gone! I thought I was going through pre menopause already because I was getting bald spots on my legs that I didn’t have to shave anymore-THE HAIR IS GROWING BACK as my hormones are coming into balance. My last period was like a dream! Easy. Uneventful. These holistic practices have been around for 1000s of years but somewhere along the line we traded our health for the convenience of popping a pill. We stopped being our own healers in tune with our bodies and we subcontracted the job out to these “Drs”. Why didn’t the Dr. tell me about cinnamon I instead of Glucophage? He doesn’t get a bonus from the pill corporations that’s why. I did the math on my weekly consumption of cinnamon oil, coconut oil and strawberries. It costs me $6.49 A WEEK to use these remedies for diabetes and hypothyroid. They will never say it’s a cure-or even viable treatment. THEY LIE TO KEEP THEIR US IN FEAR OF TRYING SOMETHING DIFFERENT. THEY LIE TO KEEP THEIR CUSTOMER BASE. When modern pharmacudical companies began THEY were the “alternative health care” Holistic natural plant based medicine has been here since the beginning-it just takes a little more time to prepare vs. popping a pill. Hope this info helps someone else.

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