Do you have type 2 diabetes? Perhaps you’re at risk for it, or someone you care about has type 2 diabetes. Approximately 12% of adults have type 2 diabetes, including approximately 25% of individuals over age 65 years.1 Diabetes is a leading killer throughout the United States, and is on the rise.
But there is good news—type 2 diabetes is reversible. Although it is not currently curable, many individuals have achieved remission or near-remission of their diabetes, meaning that their blood sugar levels are normal or nearly normal without diabetes medication.2, 3 “Diabetes Reversal” is the process of working toward remission or as close to remission as possible. So, how does diabetes reversal work?
The key to diabetes reversal is weight loss. Whether from lifestyle change or weight loss surgery, the greater the weight loss the greater the degree of diabetes reversal. Many people who achieve remission have weight losses of 15% or greater, however a 10% or even 5% weight loss can get you part of the way there. Remissions of diabetes tend to last many years, especially if most of the weight loss is sustained. However, the diabetes will return if too much of the lost weight is regained.
Diabetes goes into remission by improving the function of beta cells in the pancreas. Beta cells produce insulin, the hormone needed to control blood sugar levels. Excess body weight strains the beta cells, causing them to become over-worked and eventually fail after many years. Losing weight and keeping it off reduces strain on the beta cells allowing them to function better. The more weight you lose the better your beta cells can function and heal. 2,3,4
There is a wide range of effective eating strategies for diabetes reversal, and they all produce weight loss.5 Each strategy has a specific set of “eating rules” that need to be followed closely and consistently. Any effective eating strategy is designed with a unique set of dietary freedoms and limitations intended to create an optimal balance between effectiveness and sustainability. From the perspective of an individual with diabetes, the various eating strategies each have strengths and drawbacks depending on the individual’s medical conditions, food preferences, personality, living environment, and lifestyle. Each eating strategy works best when accompanied by physical activity and exercise.
Sticking to the plan is crucial. The greater your adherence is, the greater your chances of diabetes remission will be. Adherence results from putting yourself in the position to be successful. It starts with identifying the various reasons that are important to you and making an emotional commitment to stick to the plan because of those reasons. It continues with selecting a plan that you can follow consistently. It almost always requires a coach and support system in order to build your skills at following the plan, overcoming barriers, and refocusing after temporary setbacks. A coach provides structure, accountability, know-how, and encouragement. A coach can make the difference between success or not.
How I Help my Patients
In my Diabetes Reversal Clinic (at Tufts Medical Center in Boston6) I help patients lose weight and keep it off. I ask them to meet with me in person frequently and regularly, follow an individualized eating strategy and keep a food log for my ongoing review. If they do that, they lose weight and see corresponding improvements in diabetes. The A1c level always improves when they stick to the plan. I have had many cases of diabetes remission in the 12 years I’ve run my clinic.
To assist many more people I helped create the Boston Heart Lifestyle Program. Our program is available to all Boston Heart patients nationwide and is effective for patients with type 2 diabetes. Following our program can produce weight loss and increase the chances of diabetes remission. Our patients improve risk factors, especially when participating in our coaching program. Working with one of our registered dietitian coaches can be life-changing in many ways.
If you have type 2 diabetes I hope you can reverse it! I’d like to see you get it into remission or as close to remission as possible. If you have weight to lose I’d like to see you put yourself in the position to be successful for the long-term. Our lifestyle program and coaches are ready to serve you.
In good health,
Michael Dansinger, MD
- Gregg, Edward W. “Association of an Intensive Lifestyle Intervention With Remission of Type 2 Diabetes.” JAMA, American Medical Association, 19 Dec. 2012, jamanetwork.com/journals/jama/fullarticle/1486829?utm_source=buffer&buffer_share=92bcc.
- Adham, et al. “Diabetes Remission after Nonsurgical Intensive Lifestyle Intervention in Obese Patients with Type 2 Diabetes.” Journal of Diabetes Research, Hindawi, 31 May 2015, hindawi.com/journals/jdr/2015/468704/.
- American Diabetes Association. “7. Obesity Management for the Treatment of Type 2 Diabetes: Standards of Medical Care in Diabetes-2018.” Diabetes Care, American Diabetes Association, 1 Jan. 2018, care.diabetesjournals.org/content/41/Supplement_1/S65.
- “Endocrinology, Diabetes and Metabolism.” Lifestyle Coaching for Diabetes Reversal | Tufts Medical Center, www.tuftsmedicalcenter.org/patient-care-services/Departments-and-Services/Endocrinology/Clinical-Care-Services/Lifestyle-Coaching-Program-for-Diabetes-Reversal.aspx.