Is Type 2 Diabetes reversible?

Question

Is it possible to reverse Type 2 diabetes by using a specific diet? What about insulin-dependent Type 2 diabetes?

Answer 1

It depends on how long the patient has been on insulin, and whether "pancreatic exhaustion" has been reached.

If the person has been on insulin only a few years when there is still endogenous insulin production ( check by doing a C-peptide test ), then yes, it's possible.

See the work by Prof Taylor at Newcastle, England using extreme low calorie diets which rapidly reverse hepatic and pancreatic steatosis, restoring hepatic sensitivity to glucose levels.

And for pathogenesis https://link.springer.com/article/10.1007%2Fs00125-008-1116-7

https://www.ncbi.nlm.nih.gov/pubmed/21656330

Update: The 12 month results from the DiRECT study show that 50% of the patients in the intervention arm ( The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825–853 kcal/day formula diet for 3–5 months), stepped food reintroduction (2–8 weeks), and structured support for long-term weight loss maintenance ) went into remission off all diabetic drugs. The greater the weight loss, the more likely remission was achieved.

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext

Answer 2

As Neil Barnard explains in this video, a low fat whole food plant based diet has yielded positive results. But note here that you don't need to go full vegan for this to work, the most important element is to drastically increase your whole grain carb intake, drastically reduce your fat intake, and increase your physical activity levels. This is best done under medial supervision because your medication will have to be adjusted to deal with the increased carb load.

In contrast, the popular low carb, high fat ketogenic diet while having some benefits for diabetes patients, allowing people to reduce their medicine intake, is not usually not going to reverse diabetes, and this diet comes with serious adverse health risks. Anthony Lim explains in this video that he used to recommend the low carb approach to his patients with some success, but how doing the opposite led to complete cures.

An important factor that causes people to get type 2 diabetes and keep them diabetic is the indoctrination of the general public that eating large amounts of (unrefined) carbs is bad for health. I experience this almost every time when I'm ordering my diet in restaurants, particularly in North America. On one occasion a very obese waiter told me that the 1 kg of potatoes I ordered for dinner is bad for health.

Answer 3

Yes. T2D is reversible, with some caveats.

T2D is essentially a set of symptoms in a body that has ingested too much sugar, and has lost insulin sensitivity. "Type 2 diabetes primarily occurs as a result of obesity and lack of exercise." --wikipedia Diabetes_mellitus_type_2

T2D is an arbitrary diagnosis based on the easily-measurable blood glucose level: wikipedia Diabetes_mellitus_type_2#Diagnosis

Outside the arbitrary medical definition, which has a binary diagnosis, it's much more meaningful to talk about insulin sensitivity as a spectrum.

Some people are insulin-sensitive superstars, far better at efficiently digesting sugars than "normal" people, and generally speaking T2 diabetics are less insulin-sensitive than normal people.

A helpful analogy is IQ. The arbitrary definition of moron is a person with IQ between 50-69, an imbecile has an IQ from 20-49, and idiots have IQs below 20. That's pretty easy to measure, and also pretty meaningless. A much more useful application of IQ scores is to try to make ALL people improve their own individual IQ score over time through education.

We don't focus enough on the fasting blood glucose level, or response of blood glucose level to ingested sugar as a spectrum of insulin-sensitivity. Instead, we just have 1 label, T2D. Kinda like if we ignored geniuses, morons, and regular people, and just had a single "disease", called "dumb", for people with an arbitrary IQ, let's say below 73.

When you ask about reversing diabetes, what you're really asking is, can a person use diet to improve their insulin sensitivity, as measured by fasting blood glucose, and/or response of blood glucose to ingestion of sugar. The answer is yes!

Diet is the strongest factor in improving insulin sensitivity.

Carbs are just sugar chains consisting of 3 or more sugars, so it's useful to divide all nutrition into simply sugar, fat, and protein, and never use the word carbs again. Just call them long-chain or complex sugars, so you don't camouflage diabetes-inducing sugars as nutritive-sounding "carbohydrates".

Eating very low-sugar diets (ketogenic, atkins, or even many low-calorie diets) improves insulin sensitivity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313649/

Here are some caveats:

1. Most, if not all, T2Ds are terrible eaters who consume(d) loads of sugars, so dietary changes are difficult for many T2Ds.

2. Some damage caused by eating sugar is irreversible. If you got your legs sawed off because you were extremely insulin-resistant for a long time, they won't grow back. Somewhere around 100,000 diabetes leg amputations happen every year in the US. This is a huge problem.

3. Reversal is slow, unless the person commits to a very drastic change, like a ketogenic diet (for most people this means <40g of sugar per day). Humans usually believe in lucky positive events, and expect to see immediate feedback from any changes, but most important achievements in life require small investments of energy and attention every day, over periods of months or years. This is why so few people are financially secure, physically fit, happily married, well-adjusted, and healthy. All of the important problems in life require consistent attention and near-daily investments of effort in PROCESSES over long investment horizons. The positive events, like winning Mr. Olympia, cover modelling on Forbes, and celebrating a happy 50th anniversary, aren't really "events", so much as results flowing naturally from slow, consistent processes. The behaviors that will reverse T2D are not comfortable, and your aunt will have to take those actions every day for months before seeing any positive results.

If you can make your aunt see that sugar caused her T2D, and that not eating sugar will reverse it, and she carries a powerful enough "WHY", such as not getting her legs sawn off, being able to hike mountains with her nieces and nephews, living a long and happy life, then she will start substituting fat for sugar in her diet, and live happily ever after.

Just be aware, it's a psychological battlefield, and the same thinking and actions that got her where she is will NOT get her out.

Other Sources:

• http://www.ncl.ac.uk/press/news/2017/09/type2diabetesisreversible/
• https://en.wikipedia.org/wiki/Diabetes_mellitus_type_2#Diagnosis