Can Diabetes Be Reversed?

Diabetes is a common health concern, affecting millions of people worldwide. A common question among patients and their families is, Can diabetes be reversed? This article will explore the potential for reversing type 1 and type 2 diabetes.

Understanding Diabetes

Before we address the main question, let's first understand the two primary types of diabetes:

1. Type 1 Diabetes: This is an autoimmune condition where the body's immune system attacks and destroys insulin-producing cells in the pancreas.
2. Type 2 Diabetes: This form results from the body's ineffective use of insulin, often coupled with an insulin production decline.

Is Type 1 Diabetes Curable?

Type 1 diabetes, unfortunately, cannot be reversed or cured with our current medical knowledge. Research is ongoing, and scientists are exploring potential treatments such as islet cell transplants and immunotherapies. But as of now, the mainstay treatment for type 1 diabetes remains insulin therapy. 

Can Type 2 Diabetes Be Reversed?

While a definitive cure for type 2 diabetes remains elusive, research suggests that some individuals can manage and possibly even halt its progression. Adopting dietary modifications and achieving weight loss might allow certain individuals to maintain blood sugar within standard ranges without medications.

However, it's crucial to recognize that this doesn't equate to completely eradicating the disease. Type 2 diabetes is a persistent condition. Being in remission — maintaining healthy blood sugar levels without medication — doesn't eliminate the possibility of symptoms re-emerging in the future. Nevertheless, some individuals have kept their glucose levels in check for extended periods, mitigating the adverse health effects typically associated with diabetes.

So, what's the strategy to potentially halt diabetes? The pivotal factor is weight reduction. Losing weight not only aids in diabetes management but, in certain cases, significant weight loss might enable individuals to live without the shadow of diabetes, especially if the diagnosis was recent and there's been no reliance on insulin.

How Do You Reverse Diabetes?

Several lifestyle approaches and medical interventions may lead to diabetes remission. Let's explore the options:

1. Weight Management:

One of the most effective ways to achieve remission is by managing and maintaining a healthy weight. This is because excessive weight can influence insulin production and its utilization by the body. Current research indicates that weight reduction is pivotal in inducing remission in type 2 diabetes. Achieving weight loss shortly after diagnosis increases the likelihood of remission. Yet, there are instances where individuals have achieved remission even 25 years post-diagnosis.

For those with obesity, shedding significant weight—around 15kg (or roughly 2 stone 5lbs)—soon after a diabetes diagnosis often improves the chances of remission. However, it's worth noting that remission isn't guaranteed even after losing this weight. Still, reducing by 15kg can offer numerous health advantages regardless of remission status. Studies have found that even a modest weight loss of just 5% of one's body weight can yield substantial health benefits. Such weight reduction can lead to:

• Improved blood glucose control
• Reduced risk of related complications
• Possibly decreased dependency on medications for those who are on them.

2. Exercise:

Regular physical activity is vital for holistic well-being and can aid in weight reduction and alleviating diabetes symptoms. Here are some guidelines to consider when starting an exercise regimen, ideally with guidance from your healthcare professionals:

• Begin at Your Pace: If you're new to exercise, it's wise to start modestly. Setting realistic objectives, such as taking brief walks daily, can be a practical approach. Over time, you can extend the length of your walks and intensify the pace.
• Opt for Brisk Walks: Quick-paced walking is an effective and simple workout. It's beneficial, can be done anywhere, and requires no special equipment.
• Maintain Blood Sugar Levels: Aim to engage in physical activity at least once every two days. Monitoring your blood sugar levels before, midway, and post-exercise is vital to ensure they're within a safe range.
• Be Prepared for Blood Sugar Dips: It's always a good idea to have a snack within reach, particularly if there's a risk of your blood sugar dropping during your exercise session.

Remember, the CDC suggests that adults incorporate a minimum of 150 minutes of moderate-intensity exercise weekly. Walking is an excellent choice for many due to its accessibility and effectiveness.

3. Bariatric Surgery:  

Bariatric surgery is a medical procedure designed to promote weight loss by altering the structure and function of the stomach and digestive tract, thereby reducing food intake. In addition to facilitating weight loss, research suggests this surgery may directly contribute to diabetes remission. While the exact mechanisms remain a subject of study, one prevailing hypothesis posits that the surgery modifies gut hormones, enhancing the body's ability to regulate blood sugar levels.

Studies indicate that a significant majority—around three-quarters—of individuals experience diabetes remission following bariatric surgery. Among the various surgical options, gastric bypass and sleeve gastrectomy demonstrate more consistent long-term outcomes than gastric banding. Typically, bariatric surgery becomes a consideration for those with a BMI of 35 or above and concurrently face weight-induced health challenges, such as diabetes. The surgery often yields the best results for individuals diagnosed with diabetes for 5 years or less and who aren't dependent on insulin.

For obese and newly diagnosed with diabetes, discussing the possibility of bariatric surgery with a healthcare professional is advisable. It's essential to weigh the potential benefits against the inherent surgical risks. However, many who undergo the procedure experience improvements, often leading to diabetes remission.

4. Watch What You Eat:

A nutritionally rich diet can be instrumental in pushing type 2 diabetes towards remission and offers a multitude of benefits:

• It helps in achieving and maintaining a balanced weight
• Supports strength and flexibility
• Effectively manages diabetes symptoms
• Enhances overall physical well-being
• Counteracts potential depression and anxiety, which are frequently associated with diabetes

Consultation with your physician can guide you towards a suitable diet, or, if necessary, they might recommend a dietitian.

A diabetic diet should include the following:

• Sufficient calories to achieve or uphold a balanced weight
• Beneficial fats, like omega-3s, known for their potential anti-inflammatory effects
• An assortment of fresh or frozen produce rich in antioxidants
• Wholesome grains
• Lean protein sources, including poultry, fish, low-fat dairy, soy, and legumes
• Minimal alcohol consumption, if consumed at all
• Restricted intake of added sugars, fats, and salt
• Quitting smoking

Understanding the proper carbohydrate intake for your lifestyle and activity level is vital for diabetes management. A trained medical professional can assist in designing a diet plan that aligns with your carbohydrate requirements.

While some individuals aim for a low-carb diet, limiting to no more than 130 grams of carbs daily or roughly 26% of your daily caloric intake, it's essential to seek advice from a healthcare expert for personalized guidance.

The ketogenic diet, often touted for weight loss and diabetes management, has been the subject of varied research findings. While it may suit some, it's not universally recommended due to potential risks.

Instead of merely cutting down carbs, the emphasis should ideally be on the quality of carbohydrates consumed. For instance, whole grains offer health benefits not found in refined carbohydrates.

Ultimately, there's no one-size-fits-all approach. Unlike strict diet types, personalized dietary plans are generally more effective in managing diabetes.

Incorporating the right dietary choices and consistent physical activity plays a pivotal role in diabetes management. Such approaches can facilitate remission, decelerate disease progression, and prevent complications.

5. Medications: 

While many individuals control type 2 diabetes with diet and physical activity, medications might be essential for others to maintain blood sugar levels within desired ranges.

The necessity for medications often depends on factors like:

• The patient's age
• Current health condition
• Desired treatment outcomes

There are a variety of drugs that either decrease glucose levels or augment insulin production, including:

• Metformin
• Sulfonylureas (e.g., glipizide)
• Glinides
• Gliptins (e.g., Sitagliptin)
• SGLT2 inhibitors (e.g., gliflozins)

Should these medications prove ineffective, physicians may recommend insulin therapy. Moreover, to mitigate the risks associated with potential complications, such as cardiovascular diseases, there are other beneficial medications:

• Antihypertensives to control blood pressure
• Statins for cholesterol regulation
• Aspirin or its alternatives to deter the formation of blood clots.

6. Try Fasting: 

Fasting, intentionally abstaining from food and calorie-containing beverages for a specified duration, is a potential weight loss technique and an emerging approach for type 2 diabetes management.

A limited study highlighted the potential benefits of therapeutic fasting in reversing type 2 diabetes. In this study, participants undertook three 24-hour fasts weekly for a few months. On fasting days, they consumed only dinner; on non-fasting days, they had both lunch and dinner, predominantly focusing on low-carb meals.

Interestingly, Of these participants, two managed to discontinue all diabetes medications, while the third ceased three of their four drugs. Impressively, within 1-3 weeks, they no longer required insulin injections. Furthermore, they experienced a weight loss ranging from 10% to 18% of their initial body weight, equivalent to a loss of 20-23 pounds.

Another research angle examined the "5:2" approach, where participants consumed a minimal 500-600 calories on two non-consecutive days and a regular diet on the remaining days. The results were akin to a daily calorie restriction of 1,200-1,500 calories, with participants witnessing weight loss and improved blood sugar regulation.

Intermittent fasting has been the subject of various studies, suggesting various health benefits. Some research indicates that such fasting when practiced by individuals with chronic ailments, can lead to enhanced disease control. However, it's important to note that these studies typically span a few months, and it remains to be seen if these benefits will persist over extended periods.

For those intrigued by the idea of fasting, it's paramount to collaborate with a healthcare professional to ensure a safe and informed approach.

Taking Care of Yourself with Diabetes

Living with diabetes can be challenging, but remember you're not alone. Please take a moment to breathe deeply and handle stress as it comes. Your loved ones are there for you, offering their unwavering support. For daily comfort, consider wearing diabetic non-binding or compression socks; they're a simple step to keep your feet healthy and pampered. Every gesture of self-care counts, and your well-being is precious.