I won’t be sugar coating anything here. The journey is hard, and can be long for many. But remission, and lifelong remission too, is possible, as evident by numerous inspirational people around the world - so how exactly can you do it? Here is a collection of the latest evidence backed methods that have helped many set their diabetes into remission.
1. Weight Loss
The most evidence we have right now points towards weight loss.
The causes of type 2 diabetes are multifactorial an very complex, but in many cases it's caused by a build-up of fat inside your liver and pancreas - key glucose regulating organs. Your pancreas helps to make insulin, while your liver helps to store and release glucose when needed. So when there is a build up of fat in them, it impairs their normal function.
(Imagine going for a run, but with a sumo-wrestlers suit on - a lot harder, huh?)
Losing weight helps to cut the fat, enabling those organs to do their job. Losing weight has also been shown to
improve insulin resistance. There is a precaution though.
Many people focus on low calorie diets, as mathematically, if you put in less, and expend more, the numbers of the scale should drop. However, the important thing to factor in is sustainability, and overall health. This includes nutritional quality, as micronutrient deficiencies are another very common trait amongst people on low-calorie diets. The best diet is one you can be consistent with.
2. Exercise
Moving makes your muscles use more glucose. It’s as simple as that. Developing more muscle through resistance training creates more reservoirs for storing glucose too, helping to bring blood sugar levels down in the long term. However, there isn’t enough evidence to show that exercise alone can lower blood sugar levels enough to put type 2 diabetes into remission.
Diet still trumps.It is important to use a mixture of both, as exercise has been proven to help maintain weight loss, instead of bouncing right back.
3. Stress management
Stress makes it harder for insulin to do its work. When you are stressed, your body releases hormones adrenaline and cortisol, which can cause transient insulin resistance. If you are chronically stressed, it can keep your blood sugar levels high, leading to more complications. Stress can also be linked to emotional eating, which would no doubt impact blood sugar levels.
4. Medication
Everyone's talking about weight loss drugs. It has become so popular with the general public, there is now a shortage of these drugs for people who actually need it! Some names you might have heard of are Wegovy and Ozempic (brand names for Semaglutide), or Orlistat. Orlistat works by limiting the amount of fat your body absorbs from the food you eat, whilst Semaglutide slows down movement of food in your gut, decreasing your appetite.Medication can help with weight loss, but it’s too early to say if their effects are sustainable, as there is some evidence to show people put back the weight once they stop the drugs - not ideal.
Starting a new medication is also a big step, so speaking to a healthcare professional is very important before doing so!
5. Bariatric surgery
Bariatric surgery has consistently been shown to dramatically and
rapidly improve blood glucose. It also allows for a reduced need for oral glucose-lowering medications. In fact, it has been effective at reversing diabetes in
up to 80% of patients in the immediate term. It can also alter release of GI hormones which control satiety and the hunger response via the gut-brain axis. While it has some stark and impressive immediate effects, the studies are less clear on long term outcomes and durability. Surgery also comes with risks, so it should not be a go-to option for majority of people.
I’ve got Diabetes, but I’m a healthy weight. What now?
There are many people with diabetes who have a healthy weight and BMI - about 10% in fact. So are you stuck then? Would losing more weight be unadvisable? What else could you do?At present, most research on diabetes reversal has been done on people who are overweight or have obesity, but there are some small trials showing evidence that losing weight in individuals with a healthy weight can help visceral fat (fat from inside their liver and pancreas) and go into type 2 diabetes remission too - remember, visceral fat is different from subcutaneous fat (fat stored under the skin)This should be done with caution, and with support from your healthcare provider, as if you are of a healthy weight, losing more could be unsafe and lead to other health problems.
Is it too late for me?
I mentioned in my previous article that the ability to “reverse” diabetes does depend on a host of factors, including how far this has progressed and if you have developed any complications. If you are at quite an advanced stage, or have begun to develop some complications, it may be difficult to reverse diabetes completely. In this case, it can be helpful to focus on a long term approach of slowing the progression and preventing further complications, such as heart disease, which take years to develop.
During my medical training years, I worked with patients with type 2 diabetes in the community and in hospital. I saw the full spectrum of patients diagnosed with Diabetes, from their first review on hearing their diagnosis, to their 60th appointment where they are managing the complications, which can include diabetic foot ulcers, visual deterioration and kidney problems. What I found was that the biggest factors in reversing diabetes were hope, commitment and accountability. Some patients did it all by themselves - no medication, no coaching sessions, just sheer determination through lifestyle changes. Others needed some extra support, prompting and motivation, and at times medication to assist with this as well. But every single one of them who reversed it felt proud (and as did we for them!), for it was a victory to have overcome, and indeed reversed what was once thought to be an incurable disease. To be diagnosed isn’t to be plagued, but a motivation to make changes - for it is indeed possible. As the saying goes, if there’s a will, there’s a way.
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