Dr. Julie Chen is a board-certified internal medicine physician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Gaithersburg Medical Center.
Being diagnosed with Type 2 diabetes can be scary. Patients with this diagnosis rightfully worry about blood sugar levels, what they can and cannot eat, and whether they will have health complications, such as heart disease, vision problems, or kidney disease.
Often, patients diagnosed with Type 2 diabetes ask me whether there is a cure. Can anything be done to reverse Type 2 diabetes?
While Type 2 diabetes cannot be cured, it can go into remission. And when diabetes is in remission, people significantly reduce their risk of developing complications and chronic health conditions such as coronary heart disease.
Risk Factors for Type 2 Diabetes
Unlike Type 1 diabetes — which is usually diagnosed in childhood and cannot go into remission — Type 2 diabetes is usually diagnosed in adults. Type 2 diabetes occurs when a person’s body cannot make or utilize insulin properly. This can cause high blood sugar levels.
Risk factors for Type 2 diabetes include having a family history, being overweight or obese, lack of physical activity, and being 45 or older.
Type 2 diabetes, particularly if not well controlled, can have serious health consequences. People with Type 2 diabetes are at increased risk for the following:
- Cardiovascular disease, including heart attacks, strokes and heart failure;
- Nerve damage, or diabetic neuropathy, which often causes pain and numbness in the hands and feet as well as stomach and digestive issues;
- Kidney disease, including chronic kidney disease leading to kidney failure requiring dialysis;
- Vision loss caused by diabetic retinopathy;
- Foot problems, including peripheral arterial disease affecting the legs and feet. People with peripheral arterial disease are at risk of losing toes, a foot, or the lower leg to amputation.
Type 2 Diabetes and Remission
A person’s Type 2 diabetes is in remission when blood sugar levels return to normal levels without the use of medication. One of the best ways to achieve remission is through lifestyle modifications, including increased physical activity, eating a healthy diet, and losing weight.
Physical activity: I recommend exercising at least 150 minutes per week. Some people prefer to exercise 20 to 30 minutes daily. Others may prefer exercising 50 minutes three times a week. Do what works best for you, with the goal of exercising 150 minutes weekly, which has been shown to have cardiovascular benefits. Exercise can include a brisk walk for cardio; make sure to increase your heart rate. Also, try to work in twice weekly muscle strengthening, such as lifting weights. Muscle metabolizes (burns) sugar effectively. When you build muscle, you are helping control your blood sugar levels.
Diet and nutrition: I recommend that people who are trying to achieve diabetic remission completely avoid refined carbohydrates, because these break down the most easily into simple sugars in the bloodstream. Refined carbohydrates include white rice, white bread, white potatoes, pasta, and pre-packaged pastries.
Instead, focus on eating the following foods:
- Fiber-rich foods, such as fresh fruits and vegetables.
- Lean sources of protein, which decrease sugars in the bloodstream and support weight loss. Good sources are tofu, cottage cheese, fish, lean chicken, and turkey; avoid the skin which is high in saturated fat.
- Whole foods, such as nuts, seeds, beans, and lentils (as well as fruits and vegetables).
Weight loss: Studies have shown that if people with Type 2 diabetes can lose 10 to 15 percent of their body weight, they will often achieve remission. Weight loss causes the body to have less insulin resistance (One of the problems connected with Type 2 diabetes is the body’s cells become resistant to insulin. It’s best for the cells to be sensitive to insulin for improved sugar control).
Exercising and eating a healthy diet are vital to losing weight. Calorie restriction is important for weight loss. In addition to eating whole foods and plant-based foods, I recommend intermittent fasting to many patients. One way to do intermittent fasting is to fast for 16 hours and to eat all meals and snacks within an eight-hour window each day. During the fasting window, it’s OK to drink water, black coffee, and black tea. Studies have shown that intermittent fasting makes the body more sensitive to insulin, thereby improving blood sugar levels over time.
Bariatric surgery may be a viable option for eligible patients. Bariatric surgery has been shown to improve long-term diabetes remission.
Other Tips to Achieve Diabetic Remission
Living a healthy lifestyle can go a long way toward achieving diabetic remission. Some additional suggestions for living a healthy lifestyle include the following:
- Minimizing or avoiding alcohol. Alcohol increases blood sugar levels. By reducing how much you drink you likely will have better blood sugar levels.
- Reducing chronic stress. Chronic stress has been shown to raise blood sugar levels due to hormonal changes associated with high-stress levels. To decrease stress, try increasing social connections, and try mindfulness, or experimenting with other relaxing techniques and wellness apps for strategies like guided meditation.
- Avoiding fads. I have had patients tell me they tried ingesting large amounts of cinnamon or drank apple cider vinegar to better control blood sugar; others have tried various herbal products. There is no scientific evidence to support any of this, whereas many studies have substantiated that nutrition, physical activity, and weight loss are the way to achieve diabetes remission.
Some patients opt to purchase an over-the-counter continuous glucose monitor for short-term use, typically for a couple of weeks. Observing real-time fluctuations in their blood sugar levels — such as the spike that occurs after consuming a doughnut — can serve as a powerful motivator to make healthier dietary choices.
When patients put a structured plan into place for their nutrition and exercise, they often have great success in achieving diabetic remission. I remind patients to make sustainable lifestyle changes — choose activities they enjoy and will continue doing. Find healthy foods that are palatable. Take advantage of resources that show you how to prepare meals full of delicious plant-based foods.
Diabetic remission is possible. I have seen patients hit their goal in as little as three to six months of dedication to lifestyle changes. The effects are evident on their blood tests, and they feel positive and in control of their health, more energetic and happier.
Feature image, stock.adobe.com
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