Can You Reverse Type 2 Diabetes?

A diabetes diagnosis often raises many questions, including whether the condition is chronic or reversible. Diabetes remission research has shown that it is possible through several strategies7. Regardless of diabetes reversal success, tools and resources are available to help you live well with your condition. 

 

Table of Contents

Diabetes Reversal or Remission? Arrow icon
What Are Potential Approaches for Diabetes Reversal Success? Arrow icon
How Can I Track if My A1c Is Lowering? Arrow icon

Diabetes Reversal or Remission?

You may have heard the expressions “reverse diabetes” or “diabetes remission” to describe when people living with type 2 diabetes achieve percentage of hemoglobin molecules that have glucose attached (A1C) comparable to those without diabetes (less than 6%) or prediabetes (less than 6.4%) for at least 3 months without diabetes medications7. While both terms are used, “diabetes remission” is preferred7.

Remember to be patient if you are working toward diabetes remission. Lifestyle modifications to reverse type 2 diabetes can take time to show results and remission can be difficult to achieve7. However, the benefits of a healthy lifestyle help improve overall well-being whether remission occurs1.

 

What Are Potential Approaches for Diabetes Reversal Success?

Research on reversing diabetes, as well as reversing prediabetes (blood sugar levels higher than normal but not high enough for a diabetes diagnosis), has shown potentially effective approaches for weight loss, the primary driver of remission7. Consult with your healthcare provider before making any changes to exercise, diet or treatment regimen.

  • Low-calorie diets: Eating smaller portions can promote weight loss, and if sufficient weight loss is maintained, diabetes can remain in remission7. One study* showed that more than half of patients who sustained an 800-calorie diet achieved diabetes remission. Some of these patients remained in remission for out to 5 years, but sticking to a low-calorie diet is crucial. Support from a dietician is also beneficial3.
  • Low-carbohydrate diets: Limiting carbohydrates may help reduce the need for insulin and support weight loss5. A low or very low carbohydrate diet means that a person is consuming less than 130 grams of carbohydrates a day2. Reading nutrition labels is important to check how many carbohydrates you are consuming.
  • Exercise: Together with diet, exercise for diabetes remission may help7. These exercises include aerobic workouts (such as walking, jogging, or cycling) and strength training (exercise that includes weights or resistance bands)8. Exercise can also have an impact on reversing prediabetes4. Be sure you work with your healthcare provider when adding or changing any physical activity.

People living with diabetes who undergo bariatric or metabolic surgery may also experience diabetes remission, but keep in mind that any type of surgery may lead to complications. Surgery should only be considered for remission when benefits outweigh risks and only after other attempts to lose weight have failed6.

A1c-lowering medications are also available. Speak with your healthcare provider to see if medication may be a good option for you10.

 

How Can I Track if My A1c Is Lowering?

Along with a low-calorie or low-carbohydrate diet to reverse diabetes and exercise for diabetes remission, staying on top of your blood glucose level is required. The CONTOUR®NEXT GEN meter provides the necessary blood glucose test results for tracking progress in clinical studies and personal journeys towards diabetes remission.

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Footnote

*DiRECT Study Design: DiRECT was an open-label, cluster-randomized trial to assess whether effective weight management in the primary care setting could produce sustained type 2 diabetes remission at 12 months. Eligible participants were 20–65 years of age, had been diagnosed with type 2 diabetes within the previous 6 years, and had a body-mass index of 27–45 kg/m2.3

References:

  1. Riddle MC, Cefalu WT, Evans PH, et al. Consensus report: definition and interpretation of remission in type 2 diabetes. Diabetes Care. 2021;44(10):2438-2444. doi: 10.2337/dci21-0034.
  2. Taylor R, Ramachandran A, Yancy WS Jr, Forouhi NG. Nutritional basis of type 2 diabetes remission. BMJ. 2021;374:n1449. doi: 10.1136/bmj.n1449.
  3. Lean ME, Leslie WS, Barnes AC, et al. 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study. Lancet Diabetes Endocrinol. 2024;12(4):233-246. doi: 10.1016/S2213-8587(23)00385-6. Erratum in: Lancet Diabetes Endocrinol. 2024;12(6):e17. doi: 10.1016/S2213-8587(24)00128-1.
  4. Patel R, Sina RE, Keyes D. Lifestyle Modification for Diabetes and Heart Disease Prevention. February 12, 2024. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2024.
  5. Hallberg SJ, Gershuni VM, Hazbun TL, Athinarayanan SJ. Reversing type 2 diabetes: a narrative review of the evidence. Nutrients. 20191;11(4):766. doi: 10.3390/nu11040766.
  6. Rubino F, Nathan DM, Eckel RH, et al; Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by International Diabetes Organizations. Surg Obes Relat Dis. 2016;12(6):1144-1162. doi: 10.1016/j.soard.2016.05.018.
  7. MacKay D, Chan C, Dasgupta K, et al. Special article: remission of type 2 diabetes. Can J Diabetes. 2022;46:753-761.
  8. Johansen MY, MacDonald CS, Hansen KB, et al. Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JAMA. 2017;318(7):637-646. doi: 10.1001/jama.2017.10169.
  9. Ried-Larsen M, Johansen MY, MacDonald CS, et al. Type 2 diabetes remission 1 year after an intensive lifestyle intervention: A secondary analysis of a randomized clinical trial. Diabetes Obes Metab. 2019;21(10):2257-2266. doi: 10.1111/dom.13802.
  10. https://guidelines.diabetes.ca/cpg/chapter13