Diabetes Self-Management Blog

Can Type 2 or Type 1 diabetes be not only reversed, but cured? Can beta cells start producing enough insulin? Can the liver store glucose better, and can body cells learn to handle glucose more efficiently?

We always hear that diabetes is incurable, and so far it has been. But people are trying. Diabetes affects so many organs; we’ll have to investigate them one at a time. This week we’ll look at beta cells in the pancreas.

If you have Type 1 or 2 diabetes or prediabetes, you have damaged beta cells. So you don’t have enough insulin, and what you have may not be released when it’s needed. If the cells were healed, diabetes would pretty much go away. But is this possible, and how could it be done?

In Type 1 diabetes, cells from the immune system attack and destroy beta cells. Type 1.5 diabetes or LADA (latent autoimmune diabetes of adults) probably involves a similar process.

So restoring beta cells in Type 1 or 1.5 will probably require changing the immune system. Reducing the need for insulin by eating a healthy diet helps, but I don’t know of any Type 1s or people with LADA who recovered normal beta cell function by diet alone.

Many are looking at surgically replacing beta cells. Hundreds of experimental “islet cell transplants” have been done. But the results aren’t great. This approach will only work if we could also “turn off” whatever process is killing beta cells in the first place. But there’s a lot of money in it, so I’m sure the research will continue.

Research is going on into drugs that might stop the immune system’s attack. A drug called teplizumab is being studied and shows promise. But as a person with an immune disease of my own, I’m pretty sure this progress will be slow. The immune system is not well understood yet.

Beta cells in Type 2
People with Type 2, however, recover beta cell function all the time. A study done in Seattle found that beta cells subjected to high glucose levels (about 288 mg/dl in a test tube) lost function rapidly. But when switched to a low-glucose environment (about 15 mg/dl), most of them recovered normal insulin production.

The longer the cells had stayed in the sugary solution, the longer it took them to recover. The researchers said that the damage might be irreversible after too much time in the glucose bath. They couldn’t say how long that time would be.

In 2011, a widely-reported British study found that beta cells recovered in a couple of weeks in most (not all) people eating 600 calories a day. Most of these people had been diagnosed with Type 2 fairly recently.

A study of African-Americans with extremely high glucose (559 mg/dl, on average) was done in Brooklyn and published in 2001. Eleven of 26 people recovered beta cell function, stopped their medicines, and had near-normal A1C results after a few months. The improvement lasted for the year and a half of follow up.

Subjects had been treated with insulin or a sulfonylurea drug, and coached on diet change. The drugs are not known to heal beta cells, so it must have been the normal blood glucose levels that did it. Their beta cells had been taken out of the glucose bath.

However, 15 of 26 people continued to require drugs. Researchers said there was “no significant difference in age, sex, plasma glucose at presentation…, body-mass index, magnitude of weight change or pharmacological agents used for treatment between the two groups.” So we don’t know why some healed and some didn’t. I’m guessing the non-responders had had undiagnosed Type 2 for a longer time.

In 2009, researchers in Pittsburgh led by Dr. Andrew Stewart found that, in humans, the proteins cdk-6 and cyclin D1 caused beta cells to regenerate after they had been destroyed by diabetes. Cdk-6 is not easily measurable in rodents (where most of the research is done), so it had not been previously studied.

Dr. Stewart’s team wrote that drugs based on these proteins might stimulate beta cells growth in humans, which could put diabetes into permanent remission.

The idea of “resting” beta cells is often discussed. An article in Diabetologia in 2008 said the simplest way to rest beta cells was by reducing demand for insulin. The authors suggested this could be done with metformin, glitazone drugs, or insulin. They report on a study that showed “bedtime administration of NPH insulin resulted in significant improvements in [insulin function] in response to glucose.” However, they go on to say that no studies have yet confirmed that any of these drugs actually cause beta cells to grow back.

Healing beta cells without drugs
Can improved diet, stress reduction, and/or exercise heal beta cells? If “resting” them is important, eating fewer carbohydrates should give them a chance to recover.

Another way to take pressure off beta cells is by lowering insulin resistance. According to Charles Burant, MD,

All you have to do is [increase] your insulin sensitivity just a small amount…and you can remarkably decrease the amount of insulin secretion that you need to maintain normal blood glucose levels. So what we need to do is get…[people’s] insulin sensitivity improved so that their beta cells don’t have to work so hard.

The herbal medicine site Green Med Info lists black cumin seeds, vitamin D, berberine, bitter melon, curcumin, chard extract, and more as helping beta cells grow and heal, although mostly in rodent studies.

To me, it seems keeping glucose down is the key to regenerating beta cells. But the longer they’ve been damaged, the longer they’ll take to come back. “Longer” could stretch into “never” in the worst cases.

But most people can do it eventually. The pancreas is only one organ involved in diabetes, though. Next week, we’ll look at the liver.

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Comments
  1. Info, findings on Type 2 islet cells of pancreas recovering function when glucose stress removed is in fact incredible and show we need to do more revelent science work on type 2.

    For me, after seeing my own pancrease wake up and kick butt after removing the excess glucose stress ( after 26 years of a mess) was a shock to say the least. My sense was it took about 5 months after glucose stress removed, suddenly in a weeks time I got a rash of lows and ended up stripping out the starlix, 26 units of 75/25 insulin and also had to remove lantus as well.
    I ended up on low doses of standard humalog U-100 lispro.

    I realize this is not scientifically signifigant, but facts remain my pancreas is kicking butt whereas in past had stopped being usefull. This was watched on a cgms as well.

    I have also seen Italian studies and others all looking into the issue of the islet cells of type 2’s that seem to have been in some alternate state due to excess oxidation/glucose stress and when stress removed, islets show some recovery.

    Some of these studies were kicked off by the unexplicable results from bariatric surgery on type 2’s as well as extreme diets as well and quick recovery of pancreatic function well before any actual obvious fat loss.

    Thank you for providing this data and highlighting it.

    Posted by jim snell |
  2. Victoza seems to be able to grow beta cells however they may be abnormal which would be bad news.

    Posted by calgarydiabetic |
  3. Don’t be fooled by the medical concept that there are autoimmune diseases which supposedly make the body attack itself! By design, the body is not suicidal unless you are (consciously or unconsciously).
    Instead, the body is merely attacking toxins that have settled in the joints, blood vessels, lymph ducts, or cells. The resulting inflammation is merely a survival response and should not be mistaken for a disease, even if it involves pain, infection or proliferation of cancer cells. In reality, the immune system attempts to kill off some of the body’s own cells, especially those that have become toxic and are a risk to the survival of the body.

    For example, to understand cancer and to treat it successfully, we have to ask what’s its purpose in the body and why the immune system fails to stop it from spreading. It’s easy just to say that it’s an autoimmune disease that is out to kill the body. This notion of the body trying to commit suicide goes against the core principles of physical life. It makes more sense to acknowledge that cancer is nothing more then the body’s final attempt to live.

    Many patients and doctors assume that Diabetes (Types 1 & 2) manifests itself when the body somehow makes a mistake and thus fails to do its job properly. This idea is incorrect and defies logic and science, since there is a cause for every effect in this world. Not understanding why pancreatic cells stop producing insulin doesn’t imply that diabetes is an autoimmune disease. By developing diabetes, the body is neither doing something wrong nor is it out to kill itself. It certainly finds no pleasure in making you suffer and feel miserable.

    Just as there is a mechanism to become diabetic, there is also one to reverse it. To call it irreversible reflects a profound lack of understanding the true nature of the human body. Once the preconditions for restoring homeostasis have been met, the body will be able to use its full repair and healing abilities; just like it to does to heal broken bones, cuts and bruises.

    Healing the pancreas is not much different than healing a broken bone. Treating diabetes on the symptom level is difficult and actually prevents its cure. “Once a diabetic, always a diabetic” is a sad consequence of medical intervention.

    Posted by Bill Giman |
  4. I am a Type 1 for almost 56 years. I was a part of the Joslin Diabetes Clinic’s Type 1 Trials
    [2001 I think it was] to find out why some of us live so long with Type 1.

    It was found that most of us in this trial [50 to 67 years as a Type 1] stil made our own insulin; just not enough and the amount probably varied daily! Today, some doctors I have spoken with believe that all Type 1 patients have some beta cells working for them and again, just not enough!

    Knowing that I my system made some insulin helped me a great deal for better control! The continuous low blood glucose levels decreased a great deal; my energy returned.

    Also, using a pump I know how much insulin is on board and can adjust my sensitivity level and ratio to match my days’ activity.

    Whatever the cause for diabetes we can help ourselves more than we do with some time and effort to know what our system does with the food and activity we choose daily.

    Posted by joan |
  5. Bill Giman, that’s brilliant and totally in line with my sense of the logic involved. Can you elaborate on this in terms of therapy?

    Posted by Peter Mead |
  6. Bill - So sorry I did not see your question earlier. I am a busy lady and do not always check out the sites where I post. Keep in mind that I am not perfect and goof up like any of us do at times!

    There is no ONE answer that fits us all. Thus we can and should self educate to find what works for us as an individual.

    I have kept a Daily Log for many years. It helps my medical team also.

    With a pump, rather than with MDI, it is easier for me to have insulin delivery in a constant amount of insulin from the tiniest to a bit more to cover when my system needs a bit more help with insulin. A bit like our pancreas did before it “broke”.

    Also I learned that CHANGE is necessary for better control. Our system “talks” to us, if we listen through testing more frequently when test results say something is not quite right anymore. As we age our system is already ahead of us having to deal with diabetes. So, I adjust as needed. By this I mean after 3 days of some higher or lower test results it may be time for me to adjust my insulin delivery, exercise or carbs all three! At the same time I need to watch for outliers; an odd test result meaning way too high or low. Test again to make sure and if so; time to adjust.

    My therapist had me do some basal testing
    for breakfast, lunch and dinner. I could do each meal time test over a few days [not all one day] so I would not upset my system too much and of course, not be hungry.

    The idea we used is to test, send info to the pump, but take no bolus or food for two hours. Test again and then have some carbs. Of course if too high or low a test result, I need to treat my blood glucose level. If my tests are to high or low I forget the test for that meal; do it later. It tells if when my system is fussy and how to adjust the basal properly. There can be outliers so I must be careful not to adjust too much.

    As seen below I have several different amounts of of basal insulin 24/7. My bolus is based on carbs per meal of not more than 30 at any time.

    My days of activity are not always the same - thus I need less or more insulin or carb or exercise at different times of the day throughout a week, month etc. Then too with a pump I can suspend delivery for exercise or increase insulin for illnesses quite easily.

    Doing so I must remember that the metabolic system does not react instantly; it takes times to adjust - at least for me.

    Control is like handling a three horse team; Instead our our hands working the reins, we listen to our system, test and make adjustments. Yes, I have made a few goof-ups but as my endocrinologist told me years ago; take small adjustment steps and it is easier to correct them.

    My Basal insulin delivery today using a pump:
    0.300 @ 12:00 A.M.
    0.325 @ 4:00 A.M. to catch the Dawn Phenomenon
    0.325 @ 6:00 A.M.
    0.250 @ 9:00 A.M.
    0.325 @ 1:00 P.M.
    0.325 @ 3:00 P.M.
    0.325 @ 8:00 P.M.
    0.300 @ 11:00 P.M.

    I hope I answered your question.

    Posted by joan |
  7. I wish there was a way to correct a post before sending. Sorry for the typos.

    Posted by joan |
  8. To Bill Gilman, brilliant post!

    Posted by Anne |
  9. I just want to thank you! Every time I have Googled a question about my 10 yr old daughters resent diagnoses of Type 1 I get your blogs! They have been so informative, and on target. You seem to give all sides, and views which is so rare. I have learned a great deal, and have found great comfort from the knowledge you have shared. Please keep writing :)

    Best Regards,

    Shelby

    Posted by Shelby Holcomb |
  10. Hi Shelby

    I don’t know if your compliments were aimed at me or were for the whole Diabetes Self-Management team, but either way, thank you, and you’re welcome.

    Posted by David Spero RN |
  11. David:

    What incredible feedback and thoughts from the readers. There appears to be much hope and reason for changes in Diabetes thinking and seeing improvements in working this disease.

    Thank you!

    Posted by jim snell |
  12. I am not a frank diabetic (yet, anyway), but discovered that I was pre-diabetic with isolated fasting hyperglycemia in 2010. Since then I have been working on regaining glycemic regulation, which I consider to be the equivalent of recovering lost beta-cell mass. I had already been on a ketogenic diet since beginning of 2010, and continue to be.
    I have been also taking berberine for less than a year now. There is one Chinese research group which claims a “beta-cell rest” effect of this herbal drug, effectively.
    In recent months my capillary blood glucose measurements seem to indicate a very significant reduction in fasting hyperglycemia — sometimes (even often) I am now pretty normal (in the 70s or 80s in mg/dL). This never occurred during earlier years, except as a brief transient response to heavy resistance training (and even then not at all consistently).
    My next HbA1c reading will be the confirmation I hope for. I have one baseline HbAlc reading from Feb. 2013 after having started the berberine (which did knock me down by several tenths of a percentage point, as expected).
    I have always figured that beta-cell mass is lost very slowly (over years and decades), presumably as an adaptation to chronic stressors at the cellular level. And so one should not expect the reverse process, if possible at all, to be much quicker.
    It will also be impossible to know, if I do confirm some success, what contribution the berberine might have made. Or even whether abnormal beta-cell regrowth, as has been observed by P. Butler’s group with DPP-4 and incretin mimetic drugs, could be occurring.
    Anyway, I will try to remember to report after getting the next HbA1c test results.

    Posted by Ken |
  13. Thanks for sharing this news, Ken. I’ll have to look into berberine more. Please keep us posted.

    Posted by David Spero RN |
  14. The response by Ken about the Berberine is most curious.

    I ve used it to boot pests - giardia, bacteria out of my gut, It has always done that well. I am intrigued by the comments about its use in diabetes.

    Best wishes and special thanks for all the latest articles, treatment and comments.

    Posted by jim snell |
  15. David,
    Thank you for a very inspiring article! It just proved that our efforts are not “crazy”! My husband was recently diagnosed with Type 2 Diabetes. Our recent visit to an endocrinologist was a very upsetting experience and should not happen to anyone. My husband has been following a very strict diet eating the foods that have low GI and GL levels and are quite healthy - beans, lentils, oats, fish, chia seeds, etc.. When we visited the endocrinologist we were told that “50% of his beta cells are gone” (and that is WITHOUT any blood test results with his home measured glucose levels ranging from 5 to 7) and that he needs to stay on drugs for the rest of his life to “slow down the process of beta cells ‘death’”. We also heard from this doctor that eventually all type 2 diabetes people end up on insulin… That was very disheartening to hear … So, I started doing further research. That is when we came across your blog. Thanks again!!!
    Galina

    Posted by Dr. Galina |
  16. thank you for the article , its such an encouragement because i had heard about irreversible damage and that eventually one ends up on insulin. Today I have been encouraged and will put more effort in mantaining low blood glucose. once again thank you

    Posted by tsitsi shoshore |
  17. I’m pre-diabetic, mostly manifested by FGL around 110, and breakfast spikes around 45-60 minutes that have not exceeded 170, (depending on the carbs I ate), before falling back to around 120-130 at the 2 hour point. A1C around 5.8.

    Metformin (3×850) along with a low carb diet has me consistently FG below 100, and spikes rarely above 140, usually falling to around 100-110 at the 2 hour point. Last A1C was 5.4.

    I’ve been at this for about 3 months, now. I wa fortunate enough to have bought a home testing unit a couple of years ago that I never used, and then did a coupld of tests on a whim, and discovered pretty high numbers in the mornings. A cooperative MD, and Metformin, and a few lao-carb web-sites later, and I was on my way.

    To say I feel much better now would be a major understatement. I plan to keep up my current regimen for at least a year, and if I begin to see normal numbers all the time and no more spikes over 140, I will begin to believe that my beta cells have begun to heal. If not, I will look into the insulin idea.

    The biggest problem I had was to find a doctor who would prescribe Metformin for a non-diabetic. I am not looking forward to finding one who will let me have insulin.

    In any case, whatever your situation is, getting those numbers down can only do you good.

    Posted by Gary |
  18. Yes, keeping to salads….fish….small portions…and no poor food nutritionally….is probably the most important thing we can do ourselves…It means discipline and lots of chopping greens and vegetable…It is worth it of course. Monika. thanks.

    Posted by Monika Gallegos |
  19. I really liked this article, I found it when researching berberine. I am a type 1 diabetic, who has been researching healing type 1 diabetes for many, many years. I was Diagnosed 42 years ago. I am on a very low carb ketogenic diet, which has helped me lower my insulin requirements dramatically.
    I began taking capsules of berberine several months ago. I added it to my supplement regimen. I slowly ran out of my other supplements, which were only marginally helpful. I wanted to see what Berberine would do by itself. I am currently taking 2 capsules before each meal and I’ve had significant results. My insulin requirements have drastically reduced where I am down to only 8 units a day and I am hoping it will go even lower.
    I might add, that is very important that you test your blood sugar often, when taking berberine and you always carry something with you to raise your blood sugar when you have a low.

    Posted by Aimee |
  20. Glad I found this article. I have been on metformin, and have adopted what I call an “Under 500″ diet. under 500 Cals and Carbs per day. Still doing 200’s in my blood sugars though I have been at 150 once. Dr wants me to take Glyburaide- which i have had before which dangerous results. Gotta keep fighting this. Bring on my diabetes was my own stupid fault of eating more than I burned off fat- creating 600′+ tryglicerides for who knows how long. (I won’t go into the 11 years of “Actos” which as wrecked my heart) I want my happy pancreas back!!!

    Posted by James |

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