Type 2 diabetes and whether it can really be ‘reversed’, according to experts

Have you ever read claims that type 2 diabetes can be “reversed” and wondered if it’s true?

More than five million people are thought to be living with diabetes, of which 90% have type 2, according to Diabetes UK. Type 1 is thought to be an autoimmune disease (which occurs because the body’s own immune system has destroyed the cells in the pancreas that make insulin, the hormone that helps keep blood sugar/glucose levels in a normal range).

Type 2 diabetes occurs when blood sugar levels become too high because the body no longer produces enough insulin or the insulin does not work properly (insulin resistance).

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Over time, this can lead to a number of possible complications, including nerve and blood vessel damage affecting the eyes, kidneys and legs, as well as an increased risk of heart attack and stroke.

But can you really reverse type 2 diabetes? Natasha Marsland, senior clinical adviser at Diabetes UK, said the term ‘remission’ was a more accurate way of looking at it.

She said: “Remission of type 2 diabetes is when long-term blood sugar falls below the diabetes level and stays there for at least three months without the need for blood sugar-lowering drugs. By bringing blood sugar into a non-diabetic range. in the long run, the symptoms of diabetes and any new damage it may cause to your body are on hold.

“Remission doesn’t mean your diabetes is gone forever because your blood sugar can rise again, and we don’t call it ‘type 2 diabetes reversal’ because remission is not a cure for type 2 diabetes. You still need to participate for regular check-ups and get the support you need to treat or manage any existing complications.”

How does diabetes remission work?

Natasha added: “We know from evidence that the key to remission is weight loss. The sooner you try after diagnosis, the better your chances of remission. If you’re living with obesity, your type 2 diabetes is more likely to go into remission if you lose around 15kg (2 stone 5lb) as safely as possible.”

Weight is one of the many risk factors associated with type 2 diabetes, along with genetics and family history, age and ethnicity (people of South Asian, Chinese, Afro-Caribbean and Black African descent are generally at higher risk) .

But while it’s a key part of the remission picture, Natasha also said: “Weight loss is no guarantee of putting type 2 diabetes into remission. However, losing weight, if needed, can have a positive impact on your day-to-day health and long-term well-being and health.

“The causes of type 2 diabetes are multiple and complex, but we know that in many cases it is caused by fat building up in the liver and pancreas, preventing them from working properly.”

For some, weight loss surgery or medications (such as Ozempic and Wegovy) may be beneficial. Nutrition and healthy eating are also key.

Type 2 diabetes and nutrition

Diabetes dietitian William Hadfield said: “Most research shows us that losing weight reduces insulin resistance and blood glucose levels. However, we also know that 10% of people diagnosed with type 2 diabetes are at a healthy weight.

“People with type 2 who are unwilling or unable to lose weight may want to focus on reducing overall carbohydrate intake (eg bread, rice, pasta, potatoes, cereals) and increasing lean protein (eg beans, lentils, eggs, white meat, fish). ), as well as vegetables and healthy fats (eg, nuts, seeds, and olive, canola, nut, and seed oils and spreads).

“Staying hydrated with sugar-free fluids (eg water, sugar-free pumpkin, unsweetened tea or coffee) and drinking alcohol only within recommended limits can help with overall health, manage hunger and avoid unnecessary calories.”

William added: “For all people, but especially for those with diabetes, it is important to avoid added sugar as it is linked to obesity and tooth decay. For people with diabetes, it can help raise blood glucose levels.

“These foods (eg sweets, chocolate, highly processed foods and drinks) often have little or no nutritional value, so they rarely provide health benefits.”

Make choices that work for you

William is keen to focus on sustainable change. He said: “Choose a dietary approach that works for you and your life. Think about every aspect of your life and how food, drink and lifestyle fit into it and find a way that allows you to live your life the way you want to. live it and it also supports you in achieving your health goals.”

He suggests avoiding “overly restrictive and bland diets unless supervised by a trained and qualified health professional.”

He added: “In a world so fast-paced and driven by immediate results, we can sometimes expect the same to apply to our health. It’s important to recognize that sometimes slow and steady changes really win the race with health and type 2 diabetes.”

What else do you need to know?

Natasha emphasizes the importance of staying informed with your healthcare team.

She said: “Whether you’re thinking about trying to get your type 2 diabetes into remission, are already trying to do so, or have type 2 diabetes in remission, it’s incredibly important to have conversations with your healthcare team . You need advice and guidance that is good for you.

“It is also important to emphasize that attempting remission is not clinically appropriate for everyone. If you are trying to achieve remission, you may need to make changes to the medicines you take, which your healthcare team will be able to advise you on. increased monitoring.

“We know getting into remission can be challenging and staying there even more so at a weight that’s right for you. That’s why we’ve just launched our new remission information and support resources (available on the charity’s website) and are continuing to fund research to understand how to help more people living with type 2 go into remission and to stay there longer.”

William also believes that having “a holistic approach is essential because diabetes affects so many parts of life.”

He said: “Take food and drink into account, but also take into account mental health, exercise, sleep, support networks, relaxation, all these pieces of the puzzle come together to make up a person and it’s important to see the whole puzzle in order. to get the best results.”

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