Expert-reviewed by Ashwini S.Kanade, Registered Dietician and Certified Diabetes Educator with 17 years of experience
Fact-checked by Aditya Nar, B.Pharm, MSc. Public Health and Health Economics
Vikram Kulkarni, a 45-year-old techie from Bangalore, was diagnosed with diabetes in 2011. “I wasn’t very surprised by the diagnosis as diabetes ran in my family and I was going through a stressful period too,” says Mr Kulkarni. His doctor put him on medications. His diet preferences were reasonable and he didn’t have a sedentary life either. After a few years, when his blood glucose levels refused to go down even after medications, his doctor increased the dosage. “That’s when I decided not to let the condition dictate my life. I took up cycling and started paying attention to my diet. With conscious eating and daily walks, I have managed to reverse my diabetes and have been off medications for the past 2 years,” he reveals.
There are thousands of diabetics like Vikram who took the decision to do something about their diabetes, got on the right path and most importantly, stuck to it till they reached their goal of diabetes reversal. If others can, so can you. It has been proven that diabetes need not be a life sentence. You can look forward to a life with lower risk of complications and probably move towards a life without medicines.
“The word ‘diabetes reversal’ means complete or partial cessation of medicines with blood glucose levels near normal range, with an ideal body weight and regular physical activity,” says Ashwini Kanade, Registered Dietitian and Diabetes Educator.
The one test that can confirm if you’ve achieved remission (a state where diabetes is not getting worse) is the HbA1C test, which basically is a measure of the average blood sugar levels over the last 3 months).
According to an article published in Diabetes Care journal of American Diabetes Association, a consensus group consisting of experts in hormone system, diabetes education, transplantation, metabolism, weight-loss surgery, blood diseases and cancer, here’s how various levels of remission or diabetes reversal are defined. The recommendations are not the official position of the ADA though:(1)
|Partial remission||· Fasting sugar level 100–125 mg/dl and A1C <6.5% maintained for at least a year, achieved without medication|
|Complete remission||· Normal fasting glucose (<100 mg/dl) and A1C maintained for at least a year, achieved without medication|
|Prolonged remission||· Complete remission of at least 5 years’ duration which might operationally be considered a cure|
How does one ‘reverse diabetes’?
You can take steps to ensure you start on the path to reversal.
1. Diabetes reversal through diet and exercise
Studies have suggested that the function of your pancreas can be restored to an extent and diabetes reversed, by restricting your energy intake through diet.(2)
Initial results from another research have reported that a very low-calorie diet can help achieve diabetes remission for at least 6 months.(3)
While it seems miraculous, it isn’t completely impossible to get there. Making small changes in your diet with expert help and constantly monitoring your progress can get you started on the path to reversing diabetes. Maintaining this lifestyle consistently can help you reach your goal.
Along with diet changes, it is necessary to get enough physical exercise as well. Exercise can help you lose weight and control your blood sugar levels. (6) Here are four easy yoga asanas for diabetes that you can start off with.
2. Reversal of diabetes after bariatric surgery
If it’s been really difficult for you to lose weight and you’ve been recommended bariatric surgery by your doctor, it’s probably good for you to give it a try. Studies have shown that bariatric surgery is associated with a 45-95% rate of diabetes remission, depending on the type of procedure.(4)
And you don’t even have to wait till you’ve lost all that weight. The blood sugar levels start trending to normal way before the post surgery stage. This has been attributed to altered secretion of various hormones and the sudden negative energy balance having an effect on the metabolism.(5)
How can you achieve it?
You can reverse your diabetes with a support programme in addition to your existing diabetic care recommended by your doctor. The programme should include healthy eating, exercise and self-monitoring. According to experienced Diabetes Educator Ashwini Kanade, “Diabetes reversal is a complex task with a simple solution. It is a lifestyle disorder and has a definite line of treatment for reversing the disorder”.
Can you maintain it for life?
Reversing doesn’t mean cure. With the reversal, you successfully halt the progression of diabetes without depending on the medication. But there is a possibility of recurrence of the disease in remission. It can potentially be reversed for life by maintaining a very low-calorie diet and exercise.
What care should I take after the reversal?
You need to continue your commitment to a healthier lifestyle to ensure that you don’t have to go back to medications. With prolonged normal blood glucose levels, the risk for diabetes-specific complications such as retinopathy is likely to decline significantly. If any complications have already been established, indefinite monitoring would likely be needed.
If not, annual screening for complications is recommended till you achieve prolonged remission. After living a diabetes-free life for 5 years or more, you can reduce the screening frequency and ultimately stop it after consulting with your doctor.(1)
- Buse JB, Caprio S, Cefalu WT, et al. How Do We Define Cure of Diabetes? Diabetes Care. 2009;32(11):2133-2135. doi:10.2337/dc09-9036.
- Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011 Oct;54(10):2506-14. doi: 10.1007/s00125-011-2204-7. Epub 2011 Jun 9. PubMed PMID: 21656330; PubMed Central PMCID: PMC3168743.
- Steven S, Hollingsworth KG, Al-Mrabeh A, Avery L, Aribisala B, Caslake M, Taylor R. Very Low-Calorie Diet and 6 Months of Weight Stability in Type 2 Diabetes: Pathophysiological Changes in Responders and Nonresponders. Diabetes Care. 2016 May;39(5):808-15. doi: 10.2337/dc15-1942. Epub 2016 Mar 21. PubMed PMID: 27002059.
- Vetter ML, Ritter S, Wadden TA, Sarwer DB. Comparison of Bariatric Surgical Procedures for Diabetes Remission: Efficacy and Mechanisms. Diabetes Spectr. 2012 Nov 1;25(4):200-210. PubMed PMID: 23264721; PubMed Central PMCID: PMC3527013.
- Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia. 2011;54(10):2506-2514. doi:10.1007/s00125-011-2204-7.
- El-Badawy A, El-Badri N. Clinical Efficacy of Stem Cell Therapy for Diabetes Mellitus: A Meta-Analysis. Quaini F, ed. PLoS ONE. 2016;11(4):e0151938. doi:10.1371/journal.pone.0151938.
- Steven S, Lim EL, Taylor R. Population response to information on reversibility of Type 2 diabetes. Diabet Med. 2013 Apr;30(4):e135-8. doi: 10.1111/dme.12116. PubMed PMID: 23320491.
- Sarathi V, Kolly A, Chaithanya HB, Dwarakanath CS. High rates of diabetes reversal in newly diagnosed Asian Indian young adults with type 2 diabetes mellitus with intensive lifestyle therapy. Journal of Natural Science, Biology, and Medicine. 2017;8(1):60-63. doi:10.4103/0976-9668.198343.