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Can Type 2 Diabetes Be Reversed with Weight Loss?

DiabetesJacquie Eubanks RN BSN

Strong evidence suggests that, yes, type 2 diabetes can be reversed, but a lot depends on the timing of the diagnosis. While every year more than 1.5 million adults learn they have diabetes, an estimated 7 million adults have yet to be diagnosed. Recent studies have shown that the best chance of diabetes reversal often occurs very early in the disease onset. However, some who have been previously diagnosed can potentially put their diabetes into remission with dietary adjustments and substantial weight loss. Analysis of several studies showed that individuals with a history of type 2 diabetes who significantly reduced weight experienced remission along with a decrease in liver and pancreatic fat. As well, researchers surmise that insulin-producing beta cells thought to be dead or obsolete in diabetics, may have essentially been hibernating. It now appears that achieving a healthy weight may be sufficient to reactive them.

Largely the result of excess body weight and physical inactivity, type 2 or adult onset diabetes occurs when the body cannot effectively utilize the insulin it produces. Impaired glucose tolerance and impaired fasting blood sugar are conditions relating to the transition from normal function to diabetes onset. Those diagnosed with high blood sugar are at high risk of progressing to type 2 diabetes, although this is not inevitable as evidenced by lifestyle interventions. A common consequence of uncontrolled diabetes, high blood sugar leads to serious damage to many of the body’s systems over time. Per the World Health Organization, diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

Lifestyle approaches for the prevention, management and potential remission of an early type 2 diabetes diagnosis:

  • Reducing weight and healthy weight maintenance are cornerstones of metabolic health. Type 2 diabetes is most commonly associated with excess weight, obesity and insulin resistance. Per the BMJ, weight loss is linked to improvements in blood sugar, blood pressure and lipids, which can delay or prevent complications, particularly cardiovascular events.
  • Energy balance is calculated by the amount of calories consumed compared to calories burned through physical activity, daily routine and bodily processes. Most guidelines recommend promoting weight loss by reducing energy intake and increasing energy expenditure.
  • Perhaps the most contentious issue on the prevention or management of diabetes is disagreement on macronutrient diet composition. While some clinicians tout a low carbohydrate diet for weight and glycemic control, others conclude that a low carb diet combined with low saturated fat intake is better. The best current approach may be a focus on a healthy eating pattern that limits caloric intake and improves macronutrient quality. Evidence supports avoidance of processed foods, refined grains, processed red meats, and sugar sweetened drinks, as well as an emphasis on whole foods, including fiber-rich colorful vegetables and fruits, whole grains, healthy fats, oily fish and dairy.

Recent findings suggest that lifestyle modifications may have a bigger impact on reversing type 2 diabetes than previously believed. For many newly diagnosed individuals the choice seems clear. One can either commit to intensely focused lifestyle changes or take lifelong medication and expect diabetic health complications in the future. Weight loss first, followed by weight maintenance through exercise and proper diet should remain the focus to avoid diabetes onset and a progressive decline in health. The future looks brighter for many of those who do overhaul their diet and prioritize exercise. It now appears that the loftier goal of reversing the condition may actually be attainable for many.

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Reversing Diabetes with Weight Loss: Stronger Evidence, Bigger Payoff. https://www.endocrineweb.com/news/diabetes/60067-reversing-diabetes-weight-loss-stronger-evidence-bigger-payoff
Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes
Dietary and nutritional approaches for prevention and management of type 2 diabetes. https://www.bmj.com/content/361/bmj.k2234
Is Type 2 Diabetes Reversible? https://health.usnews.com/conditions/type-2-diabetes/type-2-diabetes-reversible