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Can Type 2 Diabetes Be Reversed?

David Spero

June 6, 2012

We’ve heard that diabetes is a chronic progressive illness. You can’t get better, you have to get worse. The best you can do is slow it down. But at least five approaches now claim to “reverse” Type 2. What does that mean?

The official expert line on Type 2 has long been that people start by controlling the condition with diet and exercise. But they move fairly quickly to pills (like metformin), then to insulin or insulin plus pills. In recent years, insulin has been started more quickly, and new drugs like the incretin mimetics are changing the progression of treatment. But it is still thought that the disease progresses and can’t be stopped.

Being told you are “chronic progressive” is like having a curse put on you. It can sap your confidence and destroy your hope. But is it true? Dozens of Diabetes Self-Management readers say no. On a blog post by Diane Fennell about a study of low-carb diets in Sweden, people commented eloquently on how they have gotten better by reducing carbohydrate intake.

Bob wrote: “By limiting carbs, my A1c dropped from an 8.6 to a most recent reading of 4.9. I also know people who eat whole-grain pasta, bread and have oatmeal every morning, because a doctor told them so, bemoaning their numbers.”

Following a different (acid/alkaline) diet, Dan wrote that his A1C dropped, and his cholesterol and blood pressure are normal. He’s off nearly all his statins, blood pressure medicines, and insulin.

Terri wrote: “I am a diabetic who eats a low carb vegan diet. I am far healthier now at 53 than ever before and maintain perfect glucose control.”

And on and on. It’s worth reading the whole thread, and there are scores of similar discussions all over the Internet. The reality is that people with Type 2 get better all the time. They reduce their medicines or get off them completely. Their glucose levels, cholesterol, and blood pressure come down and their symptoms improve.

So how do they do it? Low-carb eating is one major way. Dr Richard K. Bernstein discovered and promoted this approach in his book Dr. Bernstein’s Diabetes Solution. Many others have followed. The British Web site Low Carb Diabetic asks, “Would you treat an alcoholic with more booze, or a drug addict with more heroin? Starchy carbs are poison to all diabetics.” The site’s authors (a mix of both Type 1s and Type 2s) claim they all have normal glucose numbers and that it wasn’t hard to accomplish.

Other diets have also enabled people to get off their diabetes medicines. Vegetarian diets and vegan diets — no meat, no eggs, no dairy, no honey — are known to help prevent diabetes. One two-year study of 25,000 people in the US and Canada, found that vegans had only one fourth the risk of developing diabetes as non-vegetarians.

Many people report their diabetes greatly improved or disappeared on a vegan diet. You can see some “success stories” here. One former police officer reports that his “A1c dropped from over 9 percent to 5.3 percent, his cholesterol dropped from 221 to 148 points, and he has lost 74 pounds” over a seven-year period.

You might notice that a vegan diet is about as far as you can get from a typical low-carb diet, which is often heavy in animal products. How could they both be effective against diabetes? Both approaches are very low in sugar and processed grains. Vegans eat a lot of carbs, but they’re typically vegetables, fruits, beans, and nuts, not breads and sugars.

Bariatric (“weight-loss”) surgery such as gastric bypass and gastric banding frequently put Type 2 diabetes “into remission.” The diabetes often stops within days, before any significant weight is lost.

How? We don’t know whether the remission is due to restructuring the intestinal plumbing. Could be, but a British study last year showed that a 600-calorie-a-day diet completely reversed Type 2 in less than two months. I was very skeptical about this finding, as I wrote here, because such a starvation diet cannot be maintained, and so diabetes returned in many of the subjects.

But I missed the point that people’s insulin sensitivity and signaling did improve in just a couple of weeks. It wasn’t just that their numbers came down, but that their bodies recovered normal function, at least temporarily. So perhaps a more sustainable diet could do the same thing over the long term.

That’s what Dr. Mark Hyman, author of the The Blood Sugar Solution believes. He writes that you don’t need an extreme diet. You don’t necessarily need weight loss and you don’t need surgery. He says that just cutting out (or way down) starches and sugars, and exercising more will reverse Type 2 diabetes in about 80% of people. (He says others may have nutritional deficiencies or fungal infections that require other treatment. But he claims they can get off diabetes medicines too, with proper help.)

Critics of the “reversal” idea say there have been few studies, and that it’s too early to tell if people’s reversal will reverse itself again. But nobody’s funding large studies. We have small ones, and we have hundreds of thousands of testimonials like the ones on our blog.

To me that’s a lot of evidence that eating well and exercising can greatly improve Type 2 diabetes, maybe even eliminate it in many cases. Does that sound believable to you? Do you have a story to share about getting better? Please share it. It’s time to get this epidemic under control.



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