Brenda Khan
Type 2 diabetes is a chronic, life-threatening illness that affects over 830 million people worldwide, with 91% of cases being type 2. It is a condition in which blood glucose (sugar) levels are too high, typically due to insulin resistance. While there is no cure for diabetes, it can be reversed in most people through careful management of blood sugar levels, weight loss, diet, and exercise. The time it takes to reverse type 2 diabetes varies depending on the methods used and individual factors such as the duration of diabetes and the percentage of weight loss. Some people may see results in as little as a few days or weeks, while remission typically requires maintaining healthy blood sugar levels without medication for at least 3 months. Bariatric weight loss surgery, such as gastric sleeve surgery, has been shown to be effective in reversing type 2 diabetes in about 60-70% of individuals, but it involves serious risks and a long pre-surgical process. Other methods such as low-calorie diets, intermittent fasting, and therapeutic fasting have also been found to be effective in helping to reverse type 2 diabetes.
| Characteristics | Values |
|---|---|
| Type of diet | Low-calorie, very low-calorie, intermittent calorie-restricted, plant-based, Mediterranean, therapeutic fasting, ketogenic ("keto") |
| Weight loss | Modest weight reduction of 5-7% of body weight, or 30 pounds or more |
| Exercise | 10,000 steps a day, 2.5 hours of moderate exercise a week, 150 minutes of exercise a week |
| Surgery | Bariatric surgery, including gastric bypass, gastric sleeve (sleeve gastrectomy), and gastric banding |
| Time | Weeks, months, or years; remission can take 3 months or longer |
| Other | Reduced stress, more sleep, lower levels of fat in the liver and pancreas |
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Weight loss and diet
The amount of weight loss required to reverse diabetes varies, but it is generally agreed that even a modest amount of weight loss can be beneficial. Some studies suggest that a weight loss of around 15 kg can lead to total remission of type 2 diabetes. Others suggest that losing just 5-7% of one's body weight can be enough to prevent or delay the onset of diabetes. However, it is important to note that weight loss may not be the only factor in reversing diabetes, and other lifestyle changes such as increased physical activity and stress reduction may also be necessary.
To achieve weight loss, a calorie-restricted diet is often recommended. This may involve working with a professional to carefully control calorie intake, as this type of diet can be extreme. A very low-calorie diet may be recommended, with a daily calorie deficit of 500-750 calories. This can be combined with regular exercise, such as aiming for 10,000 steps per day and at least 2.5 hours of moderate exercise per week.
In addition to calorie restriction, the quality of the diet is also important. A balanced diet that includes fruits, vegetables, fish, lean meats, and Mediterranean-style meals can improve blood glucose levels and reduce cardiovascular risk factors. It is also important to eat smaller portions and choose foods with less fat to reduce overall calorie intake.
While diet and weight loss are crucial, exercise is also an important component of reversing diabetes. Exercise helps to lower blood sugar by improving the body's ability to use insulin. A combination of aerobic activity and strength training can maximize weight loss and reduce insulin resistance.
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Exercise
Types of Exercise
Yoga is one form of exercise that can help with diabetes, providing health benefits and a lasting transformation when practised regularly.
Walking is another accessible form of exercise that can help to reverse diabetes. One study had participants aim for 10,000 steps a day and at least 2.5 hours of moderate exercise a week, alongside dietary changes and a specific insulin and medication routine. More than half of the participants reached near-normal blood sugar without medication, and some were able to maintain those levels long-term.
Benefits of Exercise
The general recommendation is to get at least 30 minutes of physical activity, 5 days a week, totalling 150 minutes per week. However, it is important to start slowly and gradually increase the intensity and duration of workouts, especially if you are new to exercise. Ideally, you should aim for 30 to 60 minutes of moderate physical activity, at least 5 days a week.
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Surgery
Bariatric surgery is a weight-loss procedure that can help reverse Type 2 diabetes. It involves altering the stomach to induce weight loss, which in turn reduces the body's production of ghrelin, the hormone that stimulates appetite. The surgery also increases the production of hormones such as GLP-1, which has a positive effect on insulin production.
The time it takes to reverse Type 2 diabetes through surgery can vary depending on the individual and the type of surgery performed. Some people may experience a reduction in their diabetes symptoms soon after surgery, allowing them to lower their dosage of diabetes medication. Within two years, a majority of patients may achieve remission of their diabetes and no longer need medication. However, it is important to note that surgery does not cure diabetes, and symptoms may return if weight is regained.
One type of bariatric surgery is gastric bypass surgery, which reduces stomach size and reroutes the gastrointestinal tract so that food bypasses most of the stomach and part of the small intestine, leading to reduced calorie intake. Another type is gastric sleeve surgery (sleeve gastrectomy), which reduces the stomach's capacity for food and naturally leads to smaller portion sizes.
It is important to note that bariatric surgery is not suitable for everyone. Individuals with a body mass index (BMI) of 35 or higher and weight-related health problems, such as diabetes, may be considered for this procedure. Additionally, it is recommended that patients have had the disease for five years or less and are not dependent on insulin.
Before undergoing surgery, patients typically undergo a comprehensive pre-surgical process, including a psychological evaluation. During the days to weeks leading up to the surgery, patients should focus on controlling their diabetes and may be advised to stop using tobacco and certain medications. After the surgery, patients should expect a longer recovery period and closely monitor their blood sugar levels with their healthcare provider.
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Stress reduction
Reversing prediabetes and type 2 diabetes is possible through a combination of weight loss, dietary changes, stress reduction, and physical activity. While there is no definitive timeline for reversing diabetes, studies have shown that it can be achieved within a few years.
Stress management is an important component of reversing diabetes. Stress can lead to unhealthy behaviours such as emotional eating, inadequate sleep, and a lack of exercise, all of which can negatively impact blood sugar levels. Here are some strategies to reduce stress:
- Practice relaxation techniques such as deep abdominal breathing, progressive muscle relaxation, guided imagery, and biofeedback. These techniques can help to calm the mind and body, reducing the negative impact of stress.
- Aim for 7 to 9 hours of sleep per night. Sleep deprivation can increase cravings for sugary foods and make it harder to manage diabetes.
- Make gradual behaviour changes. Instead of drastic lifestyle changes, focus on small, sustainable modifications. This can include incorporating more physical activity into your daily routine, such as taking the stairs instead of the elevator.
- Manage your time effectively. Stress can arise from feeling overwhelmed or having too many commitments. Prioritize self-care and make time for relaxation and healthy habits.
- Seek professional help if needed. Stress can be complex, and sometimes it is helpful to work with a therapist or counsellor to develop effective coping strategies.
- Incorporate stress-reducing foods into your diet. For example, the Mediterranean diet, which includes whole grains, lean protein, and healthy fats, is recommended for people with prediabetes and can promote overall health and well-being.
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Monitoring blood glucose
Reversing type 2 diabetes is possible through changes to diet, exercise, and sleep patterns. Monitoring blood glucose levels is vital for anyone with diabetes. Here are some ways to monitor blood glucose levels:
Use a Blood Sugar Meter or Continuous Glucose Monitor (CGM)
Use a blood sugar meter (glucometer) or a CGM to check your blood sugar levels. A blood sugar meter measures the amount of sugar in a small blood sample, usually from your fingertip. A CGM, on the other hand, uses a sensor inserted under the skin to measure your blood sugar every few minutes. If you use a CGM, it is still recommended to test daily with a blood sugar meter to ensure accurate readings. The frequency of checking your blood sugar depends on the type of diabetes and any diabetes medications you may be taking.
Keep Track of Your Blood Sugar Levels
Monitor your blood sugar levels to understand what causes them to fluctuate. This can help you identify patterns and make informed decisions about your diet, exercise, and lifestyle choices. Keep a record of your food, drink, physical activity, and blood sugar readings to identify any correlations.
Maintain a Healthy Diet and Regular Eating Habits
Eat healthy, well-balanced meals at regular intervals, and avoid skipping meals. Choose foods that are lower in calories, saturated fat, sugar, and salt. Opt for fruits, vegetables, fish, lean meats, and consider a Mediterranean diet, which is known to be beneficial for people with diabetes. Control your food portions to manage your calorie intake.
Stay Hydrated and Limit Alcoholic Drinks
Drink plenty of water instead of sugary juices or sodas to maintain hydration without spiking your blood sugar levels. Limit your alcohol consumption to no more than two drinks per day for men and one drink per day for women.
Engage in Regular Physical Activity
Aim for at least 10,000 steps per day and incorporate at least 2.5 hours of moderate exercise into your weekly routine. Regular physical activity helps improve insulin resistance and can contribute to weight loss, which is often crucial in reversing type 2 diabetes.
Manage Stress and Get Adequate Sleep
Stress can lead to unhealthy behaviours such as stress eating and inadequate sleep, both of which can impact blood sugar levels. Aim for a healthy sleep schedule and find healthy ways to manage stress, such as meditation or light exercise like yoga.
It is important to note that the time it takes to reverse type 2 diabetes can vary depending on various factors, including the duration of diabetes, the percentage of weight loss, and the methods used. While some people may see improvements in blood sugar levels within days or weeks, achieving remission typically takes longer, requiring sustained healthy blood sugar levels without medication for at least three months.
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Frequently asked questions
Reversing diabetes with diet alone can result in intermittent progress followed by setbacks. However, when combined with exercise, it can take as little as a few days to a few weeks to see results. It is important to note that diabetes is considered to be in remission when glucose numbers are below the threshold for a diabetes diagnosis for at least three months without medication.
There is no one-size-fits-all diet for reversing diabetes. The key is to find a healthy eating style that works for you and stick to it. Some popular diets that can help reverse diabetes include intermittent fasting, the ketogenic (keto) diet, and the Mediterranean diet.
Yes, bariatric weight loss surgery can reverse diabetes in about 60-70% of qualifying individuals. This procedure alters the stomach to induce weight loss and typically involves a long pre-surgical process, including a psychological evaluation.
Yes, in addition to diet and weight loss, exercise and improved sleep patterns can also help reverse diabetes. Additionally, therapeutic fasting and certain weight loss drugs, such as GLP-1 agonists, may be effective for some individuals.
