Can You Really Reverse Type 2 Diabetes?
Type 2 diabetes affects more than 30 million Americans, while prediabetes affects over 84 million Americans, according to the Centers for Disease Control and Prevention (CDC). Those current numbers account for roughly a third of the United States population, but it’s been estimated that more than half of Americans will have diabetes or prediabetes by the year 2020.
If diabetes runs in your family or your doctor has already warned you about your A1C numbers creeping up, you may be eager to prevent a type 2 diabetes diagnosis. You may have even heard that you can reverse diabetes with diet and exercise, but is it actually possible?
“The term ‘reverse’ means different things to different people,” says Karen Nelson, registered nurse and diabetes program coordinator at Texas Health Fort Worth. “Some people use the term ‘reverse’ to describe diabetes that is managed without medication. I think ‘remission’ might be a better term to use. A person diagnosed with diabetes has both insulin resistance and a decreased production of insulin. Through lifestyle changes, like weight loss and exercise, they may be able to correct the insulin resistance and achieve good glucose control without medication, but there’s not a way to replace the insulin-producing cells that have been lost.”
Joni Killen, a registered dietitian and certified diabetes educator with Texas Health Arlington Memorial, agrees with Nelson.
“Unfortunately, we cannot change the body once we lose the insulin in our pancreas; that’s something we do not grow back, and that’s what happens when we are diagnosed with type 2 [diabetes],” she says. “Studies show that we’ve already lost about half of our insulin [by the time of diagnosis], but we can still manage this—that’s the good news. It is a condition that you can manage and take care of, as long as you learn all about it.”
Both prediabetes and type 2 diabetes can be prevented if you choose to live a healthful lifestyle and make changes to manage your weight, which Killen says is usually the first step in controlling diabetes.
“First thing we look at is your weight. A lot of us as we get older might have to lose a few pounds, but even ten pounds, twenty pounds makes a big difference!” she says.
Hearing that you need to lose weight can be intimidating. Thankfully, you don’t have to have a perfect body mass index to see results when you are dealing with prediabetes. The National Institute of Diabetes and Digestive and Kidney Disorders suggests that losing just seven percent of your total weight can make a big difference in improving your body’s ability to process sugar.
To help your body reduce the level of sugar in your blood, consider cutting back on carbohydrates, calories and saturated fats.
Killen notes that the easiest way to accomplish this starts right at the grocery store.
“Go into the grocery store and start with those fruits and vegetables, especially those non-starchy vegetables, that are already in a bag and cut up for you,” she suggests. “Like the salads that are in the bags—everything is cut up, we don’t have to spend hours anymore in the kitchen. Even the frozen vegetables are quick and easy, and that’s half your plate, right there.”
Killen adds that a lean protein or a meat alternative like beans should take up a quarter of your plate, and starches should take up the last quarter. She also suggests taking some time to set up a week or two of menus and utilize healthy, ready-made meals, which can help cut down on making that last-minute run through the drive-thru.
“Making a healthy meal shouldn’t take long at all; even the roasted chicken at the grocery store is already done, so you can bring it home and that will last several meals,” she says. “It does take some planning ahead, but even if you do two weeks of menus and then just repeat it, that can help. It does take a little effort and work at first, but once you have that down, you won’t even have to think about it—it comes automatically.”
Tracking your food intake can be a big help, too. Just stopping and recording everything you eat and drink may help you make changes. It’s easier to see areas of improvement, and you can feel good about the progress you’ve made as you log days full of healthy vegetables and lean proteins.
The next step in preventing prediabetes and type 2 diabetes is physical activity. Aim for at least 30 minutes of physical activity each day, and before the panic about intense cardio classes and daunting gym memberships sets in, Killen says exercising doesn’t have to be scary or strenuous, and can even be fun.
“Exercising really is a big, big factor, and that’s unfortunately something that tends to go off people’s schedules as we get busy, but just walking around the block is good!” she says. “I find that gyms sometimes really get me motivated, and then I can continue on my own. Having that little bit of help and being able to see everyone else around me just kind of keeps me going, but it doesn’t have to be strenuous. Simply walking around the block will make a big difference every day.
“And include your family! Those are the best times; that’s where you have your conversations. You get to talk to your neighbors, and it ends up becoming more of a social event. Getting outdoors, getting that fresh air and sunshine, and talking to your neighbors, seeing what’s going on around your neighborhood, but mainly having your own family join you can really make a difference.”
You might not be able to “reverse” a type 2 diabetes diagnosis, but both Killen and Nelson say with the right combination of food strategies, physical activity and support, you can keep your health under control and potentially prevent the disease.
“Take a look at your habits. A lot of times [diabetes] runs in families because we kind of tend to have the same eating and sedentary habits, so learning about yourself and making the changes will actually improve everybody else around you, too,” Killen says. “Your family will be able to make the changes with just being more mindful of what they’re eating and at the same time being more mindful of exercise. Everybody is different, so that’s why you need to sit down and set some goals that are gonna work for you, and if you need help, know that support is there!”
“Whether it’s pre-diabetes or diabetes, healthy eating and physical activity are the foundation for success in managing blood glucose,” Nelson adds. “Ask your doctor to refer you to someone like a certified diabetes educator or a registered dietitian who can help you create the plan that is right for you. You’ll want to learn how to keep your glucose at a safe level most of the time, how to take care of the highs and lows when things get out of balance, and how to lower your chances of developing complications.”
Nelson admits that a prediabetes or type 2 diabetes diagnosis can be scary and you may even experience a bit of denial. Although diabetes can be controlled and managed, not doing so can cause a lot of devastating complications and can even be fatal, but staying informed and finding a place of support can help calm any nerves and guide you down the right path.
“Sometimes we feel sad, or mad, or scared, or wonder ‘Why me? Why now?’ Sometimes we think there’s been a mistake, or believe that the lab can’t be right,” she says. “These feelings are all part of a process as we adjust to unexpected or unwelcome news. The feelings only become a problem when we get stuck and fail to move forward with the changes and choices we need to make to protect our health.
“I like to remind people that diabetes is not a character flaw. Diabetes is a condition where our body needs our help to use food for fuel. Most of a person’s success in managing their diabetes depends on what they do with what they know. That’s why current, accurate information based on the science as we know it to be is so important, as well as partnering with a diabetes educator who can help them get the information they can use to make the decision that is right for them.”
For more information about diabetes, Texas Health’s diabetes outpatient centers and to take a diabetes risk assessment visit TexasHealth.org/Diabetes.