Diabetes is one of the most widespread conditions in America—particularly type 2 diabetes. As of 2015, 30 million Americans had diabetes, and nearly 29 million of those people had type 2, the form that's largely caused and influenced by lifestyle factors (i.e. things you control).
For years, experts stressed that diabetes was incurable and must be managed for life by carefully monitoring blood sugar levels and taking insulin injections. More recently, however, scientific studies have been supporting a really exciting theory: Diabetes can be reversed.
Of course, chronic illnesses aren’t usually thought of as reversible—and many aren’t. Experts are split when it comes to the concept of reversing diabetes, but there is a growing body of research and a wealth of anecdotal evidence that suggests that it just might be possible.
"Getting a handle on your blood sugar through lifestyle changes like diet tweaks and exercise can make a big difference," says Jess Cording, M.S., RDN, CDN, a New York–based nutritionist. Be warned, though, reversing diabetes requires a lot of hard work, persistence, and grit.
Here, learn about what happens in the body when someone has diabetes, which type of diabetes you can actually control, and how the right diet, lifestyle, and stress-management strategies can make reversing diabetes a reality.
What happens in the body when you have diabetes?
Both type 1 and type 2 diabetes are associated with your body’s inability to properly metabolize sugar from carbohydrates, but they stem from different causes. Before we get into the nuances of each, though, it's important to understand how a healthy, non-diabetic body functions in terms of blood sugar metabolism. Spoiler: it has a lot to do with insulin.
Insulin is a hormone produced by the pancreas that's crucial for maintaining balanced blood glucose (or blood sugar) levels and allowing us to metabolize that glucose appropriately. In a healthy body, things go something like this: When your blood glucose levels rise after eating, the pancreas releases insulin into the bloodstream, where it helps move that glucose into your cells—thus balancing glucose levels in the bloodstream. Once the glucose is stored in your body's cells, it can then provide you with the energy to power you through your barre or yoga class.
But, of course, things don't always go the way Mother Nature intended, which brings us to type 1 and type 2 diabetes:
Type 1 versus type 2 diabetes
Type 1 diabetes is an autoimmune disease in which the body attacks the pancreas, damaging it and destroying its ability to produce insulin. People with type 1 diabetes are insulin-dependent, which means they have to give themselves insulin injections, and are at an increased risk for developing a number of other conditions, including diabetic retinopathy (caused by damage to the blood vessels in the eyes), diabetic neuropathy (caused by damage to the blood vessels in nerves), diabetic nephropathy (caused by damage to the blood vessels in the kidneys), heart disease, and stroke. Type 1 diabetes, unfortunately, cannot be reversed.
Type 2 diabetes, on the other hand, is often a result of poor dietary and lifestyle habits. Yes, people can have a genetic predisposition to type 2 diabetes, but individuals who are obese—weighing more than 20 percent more than the ideal weight for their height—tend to be at the highest risk, due in part to the fact that excess body fat releases substances called cytokines that negatively affect cells' sensitivity to insulin.
Leading up to type 2 diabetes, the pancreas still makes insulin, but your body doesn't use it properly. This is called insulin resistance. "With insulin resistance your cell receptor sites are blunted and blocked because of inflammation or toxins, and you're left with a backup of insulin and blood sugar, which is no bueno," Dr. Will Cole, D.C., functional medicine practitioner, told mbg.
Because of this, glucose builds up in the bloodstream, causing the pancreas to make even more insulin in an attempt to usher that glucose into cells—but it still doesn't work. Eventually, the pancreas gets tired and stops producing sufficient quantities of insulin to regulate blood sugar—at which point someone would be diagnosed with type 2 diabetes. Left unregulated, blood sugar levels can get dangerously high, leading to serious health problems such as heart disease, stroke, kidney disease, eye problems, nerve damage, and foot problems.
Is reversing diabetes possible? Here's what the research says
While type 1 diabetes cannot be reversed, a number of health experts believe that adopting healthier habits can reverse the course of type 2 diabetes. Reversing diabetes means getting to a point where the body resumes normal, healthy metabolism of sugar. Researchers have described "diabetes remission" as when a patient's blood glucose levels go back to non-diabetic levels (i.e., a result of less than 126 mg/dL for a fasting blood glucose test).
But, the answer to this all-important question "can you reverse diabetes?" also depends on who you ask. There are definitely experts who believe it can be, and some studies back up this point of view. For example, significant lifestyle changes such as ramping up physical activity has been shown to reverse the course of type 2 diabetes.
In an extensive study conducted by researchers at the University of Alabama Birmingham, 5,145 overweight adults with type 2 diabetes were randomly assigned to either an intensive, lifestyle-based weight-loss program or to a diabetes support and education program.
The group in the lifestyle change program reduced their calorie intake significantly and worked out for at least 175 minutes per week, in addition to attending counseling meetings several times per month. The support and education group were offered three group counseling sessions each year that focused on diet, physical activity, and social support.
After one year, 11.5 percent of the lifestyle change group saw their diabetes go into remission, compared to just 2 percent in the support and education group. After four years, 7.3 percent of the lifestyle change group were still in remission, compared to a steady 2 percent of the support and education group. Remission in both groups was more common among participants who had lost more weight and greatly increased their physical activity.
Other experts feel that what some people interpret as a reversal of diabetes is just a short period of remission and that the disease will eventually come back. But we think that's kind of a negative way to look at things, don't you?
6 ways to reverse diabetes—or at least manage it like a boss
If you or someone you know has been diagnosed with type 2 diabetes and hopes to beat the disease, here are six steps you can take to increase your chances of remission. If do you take any of the steps below, just be sure to inform your doctor, who will likely perform regular bloodwork to monitor your progress and (if applicable) help you scale back on insulin safely.
1. Start immediately
We're not expecting you to make all the changes at once, but whatever approach you start with, start now! A major factor in reversing diabetes is time. Some experts say that remission can be achieved if patients can normalize their blood sugar levels without medication in the first three to five years after diagnosis.
2. Lose weight
Weight loss is the primary factor in reversing type 2 diabetes because excess fat plays such a direct role in affecting insulin production and use. Patients need to lose, on average, 33 pounds for diabetes remission, according to one one study. But don't let that freak you out. "If you have a significant amount of weight to lose, reducing your body weight by even just 5% has been shown to have an impact on your blood sugar levels," says Cording.
Research has shown that bariatric surgery can reverse type 2 diabetes. This is an extreme measure that should be discussed in depth with your doctor, but since studies show that the surgery is one of the few methods of reversing diabetes long term, it’s worth considering if your doctor thinks you would be a good candidate for the procedure.
You certainly don't have to undergo surgery to lose weight (see the next two tips below), but if that is the route you take, you can't overlook diet and lifestyle changes. Some studies indicate that up to 60 percent of people who have bariatric surgery will see their diabetes return within 15 years, likely due to falling back into their pre-surgery habits.
3. Build some muscle
Losing any amount of weight (and keeping it off) is pretty tough without moving your body. While any type of exercise that you enjoy and can maintain for the long term is great, some experts believe that one type is particularly effective for managing or reversing diabetes: Strength training.
“It naturally restores your muscles’ insulin sensitivity," says JJ Virgin, celebrity nutrition and fitness expert. "And, if you have less body fat and more muscle, you will also need less insulin. That's because when you increase muscle mass, you burn more calories, which helps keep blood sugars at a healthy level. You also store glucose as glycogen in your muscles, so more muscle means more room to store glucose, which can also help with blood sugar balance.”
Wondering what strength training (aka weight training) actually looks like? It's not all dumbells and deadlifts. Essentially, anything that provides resistance can get the done. That means bands, weight machines, and free weights like kettlebells, barbells, and dumbbells. If you're new to strength training, start with some bodyweight exercises that require no equipment and work your way up.
4. Change your diet
Since normalizing blood sugar levels is key to reversing diabetes or pre-diabetes, changing your diet is absolutely essential. But what does that mean? In terms of an overall dietary approach, anyone who wants to balance blood sugar and reverse diabetes should adopt a whole foods-based diet rich in foods containing nutrients that help maintain balanced blood sugar and reduce inflammation.
What to eat (and avoid)
A diabetes-friendly diet should include fiber-rich foods such as whole grains and non-starchy veggies like kale and other leafy greens; healthy fats such as salmon, olive oil, and avocados; mineral-rich nuts and seeds; and deeply hued, antioxidant-rich produce such as purple cabbage and blueberries. It should also prioritize complex carbs like whole grains and starchy veggies (e.g., beans, lentils, sweet potatoes) over refined carbs like bread. Blood sugar-balancing herbs and spices, like cinnamon and fenugreek, are also worthy additions meals. And eat protein, plenty of protein!
"You want to emphasize clean proteins like wild fish, organic pasture-raised eggs, organic poultry, and grass-fed meat," says Cording. "If dairy is part of your diet, I often recommend whole milk plain Greek yogurt because aside from having a lot of protein, the higher fat content buffers the breakdown of the lactose."
A diabetes-friendly diet should not include anything that results in drastic spikes and dips in blood sugar or promotes inflammation. This means most processed foods containing refined carbs, added sugars, and unhealthy, ultra-processed fats like vegetable oil and partially hydrogenated oils (i.e., trans fats).
When to eat it
Practicing portion control and spacing out your carbohydrate intake over the course of the day is vital. You also want to make sure that you’re including protein and/or fat at each of your meals to buffer the breakdown of the carbohydrates you do eat. "The appropriate amount of protein, fat, and carbs will vary from one person to the next," says Cording, "so this is a great time to work with a registered dietitian or certified diabetes educator to help you establish a healthy pattern."
As for what dietary change has the biggest impact on reversing diabetes or pre-diabetes: "For my clients, the game-changers are most often reducing carbohydrate portion size and incorporating protein into each meal and snack," says Cording.
5. Supplement strategically
While not essential for reversing diabetes, certain supplements (when combined with an overall healthy diet and regular exercise routine), can certainly give you a leg up due to their beneficial effect on insulin, blood sugar, and inflammation. Here are a few expert-recommended picks to consider if you have diabetes or pre-diabetes:
Vitamin D. The sunshine vitamin seems to improve glucose tolerance and insulin resistance, says Virgin. In one study, supplementing with vitamin D for 12 weeks decreased body fat by 7 percent, which could be one reason for this effect. Low levels of vitamin D are also linked to metabolic syndrome, a risk factor for diabetes.
Fish oil. "Omega-3 fats in the form of fish oil convert the potentially harmful very low-density lipoproteins (VLDL), which are linked to diabetes, into less dangerous low-density lipoproteins (LDL)," says Dr. Cole.
Multi-mineral. Chromium, magnesium, vanadium, and zinc all support blood sugar control and increase insulin sensitivity. For instance, Dr. Cole says, "when chromium levels are low, HDL levels fall, insulin resistance develops, and triglycerides rise."
Magnesium. You probably need even more magnesium than what you'll find in a multi-mineral. One study found that people with a higher magnesium intake were at decreased risk for metabolic syndrome, while another study found that regular magnesium supplementation improved insulin sensitivity.
Alpha-lipoic acid. In several studies, alpha-lipoic acid was helpful in balancing out blood sugar levels and improving insulin resistance. "This antioxidant also strengthens immunity, improves energy in cells, protects brain cells against excitotoxicity, and removes excess toxic metals," says Dr. Cole. Suggested dose for blood sugar control is 200 milligrams three times a day.
Adaptogens. "Adaptogens are awesome at balancing out hormones and inflammation," says Dr. Cole. One study found the adaptogen American ginseng berry juice could significantly improve glucose tolerance and normal blood sugar levels after just 10 days.
6. Manage your stress and sleep
It’s important to take as many steps as possible to control and lower blood sugar levels, and surprisingly, they don't all involve diet and exercise. Research has shown that getting plenty of sleep and keeping your stress level under control is also paramount. Any activity that sparks joy and gets you out of your busy head (e.g., listening to a podcast, having a living room dance party, reading a book) is great for stress-relief, too, but if you need a little inspiration, check out these fool-proof ways to manage stress in your life. Or try this 10-minute yoga sequence for relaxation. And if sleep eludes you, check out these holistic ways to get more quality shuteye.
Bottom line: Even though it’s not totally clear if you can reverse diabetes permanently, there’s plenty of evidence suggesting you can prod it into remission and reduce your need for insulin and other medications. Plus, the benefits of making the above changes can be huge for your overall mental and physical health.
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