You’ve seen the question in social media clickbait. Our experts explain the hype.
For 20 years, experts have considered type 2 diabetes a predictably progressive disease: Once you’ve been diagnosed, you may slow the progress, but you can’t stop it.
But what if that downward spiral isn’t inevitable? What if you can reverse type 2? New British research suggesting exactly that is making headlines.
Cure vs. reversal
Those words might seem interchangeable, but they aren’t when it comes to type 2 diabetes. As of yet, there is no “cure.” However, type 2 can be put into remission with your meal plan, physical activity, and medications—but if you stop, it will return. For that reason, most experts prefer the term reversal.
“Cure means you won’t contend with this issue any longer,” says Ann Albright, Ph.D., RD, director of the Division of Diabetes Translation at the CDC. “If you can stop taking medications, you’ll still need to eat healthy foods in suitable portions and move more to keep type 2 diabetes in remission.”
Where the rumors came from
While scientists investigate possible treatments, like stem cell or fecal transplants, currently only one thing has been shown to reverse type 2 diabetes. “It’s very clearly about weight loss,” says Roy Taylor, M.D., director of the Magnetic Resonance Centre at the University of Newcastle in England.
Taylor caused a stir recently with research suggesting that eight weeks on a 600-calorie-a-day liquid diet, followed by careful transition back to normal eating, might be enough to reverse type 2. In one study, a small group averaged a loss of 32 pounds, and more than half saw blood glucose return to nondiabetic levels.
But Taylor’s method isn’t recommended by mainstream experts. “There are multiple reasons we don’t recommend very quick weight loss, other than bariatric surgery. The success rate is very low,” says George King, M.D., chief scientific officer at the Joslin Diabetes Center. And many people with type 2 find success with less drastic weight loss.
“It’s very clear, from multiple studies, all you need to lose is 5 per cent of your body weight to
improve insulin sensitivity,” King says. For a 300-pound person, that’s 15 pounds. While 5 per cent may not be enough to completely reverse diabetes, it should slow the progression. Just as important: keeping those lost pounds off.
The weight loss method doesn’t seem to matter—in studies, bariatric surgery, very-low calorie diets, and a combination of intensive caloric restriction, exercise, and medications have all been effective. Scientists can’t yet predict who will see a reversal or how much weight a person might need to lose. Everyone has a personal fat threshold: the point at which type 2 develops or goes into remission.
Think about it: More than two-thirds of Americans are overweight or obese. “Yet only 10 percent have diabetes,” King says. “Most people who are overweight or obese don’t have it.” Their fat thresholds may simply be higher.
Timing is everything
The longer you have type 2, the longer your beta cells work overtime to produce insulin. Eventually those cells begin to die off. Once that happens, the odds of reversing diabetes decrease.
In Taylor’s study and another recent one involving bariatric surgery, a substantial number of
participants achieved remission—but among those who’d had diabetes for more than 10 years, it was much less common.
Still, if you’ve had type 2 diabetes for more than a decade, don’t lose hope.
“Eating better and being more active makes diabetes management easier, lowers risk for serious complications and other chronic diseases, and improves overall well-being,” Albright says. “Even without remission, there is much to be gained.”