Type 2 diabetes is referred to as a "lifestyle" disease because it is the accumulation of several lifestyle factors that typically leads to its onset. But here's the good news; if it was lifestyle that set the stage for diabetes, then lifestyle may just be your ticket out.
With medical conditions like diabetes, you have more power than you might think.
In this article, we'll explore what diabetes is, how it develops, and what steps you can take to start to reverse it.
How Does Type 2 Diabetes Develop, And Can You Reverse It?
Type 2 diabetes is a condition that's characterized by uncontrolled glucose levels and dysfunction in the hormone insulin. Exactly how diabetes develops is still up for debate, but research shows that two processes typically create the conditions for diabetes:
- The cells in your pancreas (known as beta-cells), which are responsible for secreting the hormone insulin, become damaged and are unable to carry out their normal function (they can't make enough insulin). Therefore, beta cell dysfunction can drive high glucose concentrations in your blood.
- Your cells become desensitized to insulin signaling, which further drives high blood sugar concentrations as insulin is required to shuttle glucose out of the blood and into cells.
Some research suggests beta cell dysfunction often precedes the loss of insulin sensitivity. So the question becomes, why do our beta cells become dysfunctional?
Again, we don't have a cut-and-dry answer for this, but we do know that fat accumulation in the liver and pancreas seems to play a significant role. As people gain weight, fat starts to build up in the liver, which leads to excessive export of fat throughout the body. As fat stores become increasingly full, fat can eventually start to accumulate in organs and tissues that would not normally store fat (such as the pancreas).
When the pancreas is overloaded with fat, it impacts the function of its beta-cells, and its ability to release insulin becomes diminished.
In short, excessive weight gain drives obesity, which leads to beta-cell dysfunction, insulin resistance, and eventually type 2 diabetes.
But can you reverse it?
While there is no "cure" for diabetes, research shows that with the appropriate lifestyle factors in place, you can reverse the progression to the point of remission. So let's dive in.
Lifestyle Changes That Can Help You Reverse Type 2 Diabetes
It was once believed that diabetes and beta cell dysfunction were progressive and irreversible conditions. Today, however, research shows us that with weight loss, fat accumulation in the liver and pancreas can reverse itself, and eventually, beta cells can restore their normal function. As mentioned, a common hypothesis is that beta cell dysfunction is at the root of diabetes progression.
Several studies have shown that when individuals with diabetes follow a weight loss diet, they not only lose pounds, but markers for diabetes such as insulin resistance and glucose regulation return to normal or near normal levels. These shifts often allow them to discontinue their diabetes medications.[4,5]
This is fantastic news for people that are struggling with glucose control, but how exactly does one go about shedding pounds? Read on.
Try a Low-Carb Diet
There are many different ways to lose weight, but when you have type 2 diabetes, it's crucial that you keep blood sugar regulation in mind. This means that crash diets are a no-go (as they should be for everyone), and the quantity and quality of your macronutrients are vital.
With this in mind, it makes sense that following a low-carb diet would help curb glucose spikes, but research shows that restricting carbs can actually do much more.
In a systematic review of 23 different trials, investigators found that, on average, low-carb dieting for six months produced weight loss, improved HbA1c levels (glucose marker), enhanced insulin sensitivity, and promoted healthier blood triglycerides. In all, the study authors noted that low-carb dieting produced significantly favorable outcomes in reversing diabetes when compared to diets that did not restrict carbohydrates.
How low should you go? Your carbohydrate threshold will be individual to you, but you can learn more about low-carb dieting by working with a dietician or signing up for a program like BioCoach, which walks you through the process of a low-carb lifestyle.
Keep in mind that not all low-carb options are considered healthy foods, so the more whole food your low-carb diet is, the better.
Increase Physical Activity
Exercise not only helps to burn extra calories, but research shows that when you're physically active, it can enhance your body's sensitivity to insulin and improve blood sugar control.
When paired with a healthy diet, exercise can be the perfect step to supercharge your diabetes reversal process.
What type of exercise plan should you follow? There are no hard-and-fast rules; just make sure you're moving your body. If you're new to exercise, start with a brisk walk of 20 to 30 minutes or a beginner yoga class.
You may eventually decide you want to try a dance class, resistance training, HIIT workouts, or some other form of movement that calls to you. The great thing about exercise is that you get to choose what works for you, and ultimately it should be a fun, stress-relieving activity.
What's The Long-Term View Of Diabetes Remission?
To officially reach a state of diabetes remission, your blood glucose levels or markers must stay in the non-diabetic range for at least six months without the use of medications.[9,10]
At this point, you have reversed your diabetes progression.
However, it's important to note that although your clinical markers are under control, there currently is no "cure" for diabetes. This means that it's vital that you keep up with the lifestyle changes that you've made to achieve remission. If you start sliding into old patterns, you run the risk of fat accumulation and eventually losing control of your insulin and blood sugar once again.
In addition to maintaining your healthy lifestyle changes, you'll also want to stay on top of your numbers by checking your blood sugar and having your HbA1c tested every so often.
Remission is a wonderful achievement, so the motivation to stay on track with your dietary changes and physical activity won't be hard to find.
Remission of type 2 diabetes is much more attainable than most people think; it just takes an orchestration of the right lifestyle factors.
Along with general healthy eating, following a low-carbohydrate diet can help you get your blood sugar levels under control while re-sensitizing your body to insulin.
Keep in mind that while a low-calorie diet might help you lose body weight, it may not hit the metabolic markers you need to reverse diabetes.
When you add exercise to the mix, you enhance your chances of reversal even more, as exercise helps to improve insulin resistance.
For people who are still in the prediabetic range, focusing on diabetes management can reduce diabetes risk along with risk factors for prediabetes, heart disease, and other health problems.
To learn more about diabetes management and the lifestyle factors that can help you turn things around, check out the BioCoach program to see if it’s the right fit for you.
- Cerf, Marlon E. "Beta cell dysfunction and insulin resistance." Frontiers in endocrinology 4 (2013): 37.
- Taylor, Roy, et al. "Nutritional basis of type 2 diabetes remission." bmj 374 (2021).
- Lim, Ee Lin, et al. "Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol." Diabetologia 54.10 (2011): 2506-2514.
- Lean, Michael EJ, et al. "Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial." The Lancet 391.10120 (2018): 541-551.
- Goldenberg, Joshua Z., et al. "Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data." bmj 372 (2021).
- Ades, Philip A., et al. "Remission of recently diagnosed type 2 diabetes mellitus with weight loss and exercise." Journal of cardiopulmonary rehabilitation and prevention 35.3 (2015): 193.
- Nagi, Dinesh, Clare Hambling, and Roy Taylor. "Remission of type 2 diabetes: a position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS)." British Journal of Diabetes 19.1 (2019): 73-76.