Follow-up is too short. There’s no telling how long the benefits of these diets will last because they haven’t been studied for long enough. In weight-loss diets, 90% to 95% of dieters regain all the weight they have lost within five years, and usually within two years. It is possible that diabetes reversal will also fail over time for most people. In the case of starvation diets like Dr. Taylor’s, very few people can stay on them for an extended period. In his study, 4 of the 11 subjects had relapsed to diabetes-level blood glucose levels after only three months. Most of the rest probably have by now.
According to health writer Kimberly Pollock, a Dutch study found that “83% of gastric bypass patients and 62% of gastric banding patients were able to stop taking medication for their diabetes within a few days of surgery. Even at one- and two-year follow-ups, those patients remained off medication. However, by the 10-year follow-up, only 36% of all patients were able to maintain normal blood glucose levels without medicine.”
But many low-carb, vegetarian/vegan, and traditional diets are not calorie-restrictive and may be sustainable. They are described by proponents not as diets but as permanent lifestyle changes. Some of Dr. Ripich’s successful readers say that the new foods they have adopted on his diet are much more enjoyable than the sweets and starches they have given up. Some followers of Dr. Bernstein’s approach have been sticking with it for 20 years or longer, with normal or near-normal blood glucose levels throughout that time.
It’s too difficult. Some critics say that very few people can stay on programs like these. Changing eating habits is hard, especially when your friends, coworkers, and family members continue to eat in ways that are unhealthy for you. Sweets and starches are widely available, cheap, and tasty. Healthy food is harder to get, more expensive, and less familiar to many people’s tastes. Getting exercise is also hard for many people, especially when they’re not used to it, when they’re too busy or too tired, or when their environment doesn’t provide an easy way to do it. So it may be unrealistic to expect many people to make these changes.
Many people who claim to have reversed diabetes, however, say it was no great feat. The Low Carb Diabetic Web site’s authors claim that they all have normal glucose numbers and that it “wasn’t hard to accomplish.” Diabetes Self-Management Blog reader Anna writes that after she was diagnosed with Type 2 diabetes 11 years ago, she changed her diet and exercise patterns and has been off all drugs, with normal glucose numbers, for more than 5 years. “It can be done, and it actually can be done quite easily,” she says.
Anna points out that “reversal” doesn’t mean you can forget all about diabetes. “You will never be able to lounge on a sofa popping bonbons” she writes, “but you will also not have to be a prisoner to drugs and symptoms and worry over a future consumed by illness.”
People can’t change or don’t want to change. Doctors often prescribe weight loss to patients, who usually don’t lose it or don’t maintain whatever loss they achieve. So many doctors have the sense that people can’t change. But weight loss is a bad indicator of what people are capable of doing in other areas, simply because it is so difficult; our bodies try very hard to regain lost weight. If given a goal that they can actually accomplish, many people are willing to make changes and to work hard in the process.
It doesn’t work for everyone. This is certainly true. According to Dr. Hyman, about 20% of people experience nutrient deficiencies, chronic infections, intolerance of dairy or gluten, chemical toxicities, low thyroid function, or other problems that can reduce the effectiveness of lifestyle changes and will need correction before diabetes can be reversed. Other people who supposedly have Type 2 diabetes may actually have Type 1 or MODY (maturity-onset diabetes of the young, or monogenic diabetes) and will continue to need insulin, although lifestyle changes may still improve blood glucose control. Drs. Bernstein, Hyman, Parker, and Ripich all advise seeking help from a doctor when making any changes to your self-management routine.