“Is type 2 diabetes reversible, doctor?”
It’s a common question I get asked by many people that I meet.
When I was back in medical school more than 10 years ago, we were all taught that type 2 diabetes is a chronic disease. Which means that it will be there with you 24 hours a day, 7 days a week and it doesn’t go away. Essentially, it is incurable. And once you’ve been diagnosed with diabetes, the best you can do is to try to manage it as best as you can.
Today, the answer is no longer clear cut. Thankfully, in a positive way. Let’s take a deeper look at what the science tells us.
What is Type 2 diabetes?
Type 2 diabetes is a relatively common metabolic disorder that results in high blood glucose levels in your body. Did you know that over 415 million people today are living with diabetes globally? If you have diabetes, you’re far from being alone.
The condition arises from a combination of high insulin resistance in the tissues of our body and decreased insulin secretion by the pancreas, an internal organ. Insulin is an important hormone that allows our cells to properly absorb and use glucose. Insulin serves to regulate our blood glucose levels and keep it at a constant, normal level.
Some factors that can put you at higher risk of Type 2 diabetes include a strong family history of the disease (genetics), obesity (lifestyle) and age.
If you’re worried that you may have diabetes, you can find out more about the symptoms of diabetes here.
Is Type 2 diabetes reversible?
Even though diabetes is commonly thought of as a chronic disease, our understanding of it has improved greatly over the past few years. Here is where I want to point to 2 particular areas that can shed some light on this matter:
1. Sustainable weight loss may answer the question “is type 2 diabetes reversible?” in some patients.
A recent scientific study done at the University of Newcastle showed that Type 2 diabetes is a potentially reversible condition. In this early study, a number of participants with Type 2 diabetes were able to achieve continuing remission of diabetes for at least 6 months – through a robust and sustainable weight loss program following a very low-calorie diet (VCLD). This means that these participants were able to maintain a fasting blood glucose level that was essentially in the normal range (< 7 mmol/L).
This VCLD consisted of a liquid diet formula (43% carbohydrate, 34% protein and 19.5% fat at 624 kcal/day). In addition, up to 240g of non-starchy vegetables were consumed. Not an easy diet for most of us to follow!
The hypothesis is that these participants were able to lose enough weight to reduce the amount of fat in the pancreas and in so doing, allows the pancreas to secrete normal amounts of insulin.
“We have shown that it is possible to reverse your diabetes, even if you have had the condition for a long time, up to around 10 years. The study also answered the question that people often ask me – if I lose the weight and keep the weight off, will i stay free of diabetes? The simple answer is yes!”
– Professor Roy Taylor, MD, FRCP
Hence, achieving and maintaining a healthy weight is the key. While the results are promising, this was a very small study (30 participants), and we will need further research to be able to generalise the findings to larger populations.
2. Type 2 diabetes may be curable after bariatric surgery
For obese patients, bariatric surgery is a potentially curative treatment for type 2 diabetes. One of the more popular bariatric surgeries is the Roux-en-Y gastric bypass. This is a surgical procedure where the stomach is bypassed and so the intestine becomes the most important tissue for glucose use. It is more commonly used for morbidly obese patients for weight loss.
A recent study on over 20,000 patients showed that 84 percent of patients who underwent a gastric bypass had a complete reversal of their type 2 diabetes, even before they lose a significant amount of weight. The results were also found to be persistent for the rest of their life. That’s quite remarkable!
But before you schedule an appointment with the surgeon, there are a few caveats. Bariatric surgery is a major surgical procedure. It carries with it a risk of complications and event death (although small). Hence it is not for everyone – it’s commonly recommended for patients with morbid obesity where the benefits greatly exceed the risk of the surgery.
Upcoming research – a cure for diabetes
In the last 5 – 10 years, there has been a lot of money poured into diabetes research. Many smart, talented people have dedicated their lives researching new ways to treat and even cure diabetes. We’ve understood a lot more about it, compared to a decade ago.
While much of this research is still at an early stage in terms of being translated into actual treatments, several findings have been quite promising! Let me highlight a few here
In this study published in March 2017 – diabetes reversal by inhibition of the low-molecular weight tyrosine phosphatase: a special molecule has been found to protect mice from developing diabetes without affecting body weight, and could be beneficial for treating type 2 diabetes. If you’re wondering why we’re doing research on mice – these small and furry animals share 92% of our genes. We’re not too different, at least from the genetic standpoint!
Another interesting study has also been published in March 2017 – Gut microbial metabolites limit the frequency of autoimmune T cells and protect against type 1 diabetes. Again, it was done on mice and not humans. But it showed that medicinal foods or metabolites may represent an effective and natural approach to counter numerous defects that contribute to diseases like Type 1 diabetes.
In another 5 – 10 years, I’m certain that we will have much better tools and knowledge to combat diabetes.
What can I do if my diabetes is not reversible?
Don’t fret! For the majority of people with diabetes, even if you can’t reverse or cure your condition, you can still live a good, long and healthy life! There are 3 things you have the power to do, that will reduce your risk of complications from diabetes:
- Eating Right
- Exercising More
- Monitoring Regularly
1. Eating Right
The food that we eat is the most important contributor to our blood sugar levels. Particularly carbohydrates (eg rice, bread, pasta) which metabolise into glucose in our digestive tract. And since we are in full control of the food that put into our mouths each day, it means that you can develop the right eating habits that will keep your blood sugar levels in check.
Here are a couple of relevant articles that answer your common food-related questions:
2. Exercising More
Exercise helps our body to use the excess glucose in our bloodstream better. It increases our body’s tissues sensitivity to insulin. Everything adds up – not just jogging, cycling, swimming, but even activities like brisk walking or taking the stairs at your home or workplace.
Exercising is not so much about losing weight. So don’t be disheartened if you start an exercise program and realise your weight doesn’t change much. You still reap the metabolic benefits from exercise even without losing weight.
3. Monitor regularly
If you keep close tabs on your blood glucose levels, you will understand how food and activities affect your body. Use your glucometer (get one if you don’t already own one) to test your blood sugar levels before and after your meals and activity. Over time you’ll start to understand your body a lot better than before.
Be familiar with your A1c test result – this is an indicator of how well you’re managing your condition. Your doctor should discuss this with you on a regular basis. Check out this detailed article if you want to know more about this, and how you can lower your A1c.
There is no easy answer to ‘Is type 2 diabetes reversible?’. Over the past 5 – 10 years, there has been a lot of research into diabetes. We’re starting to understand this disease better, and will continue to do so in the future. In certain circumstances, we’ve even found that type 2 diabetes is a potentially reversible or curable condition. This is through diet, weight loss and bariatric surgery.
And even if it is not, making the right changes to your lifestyle by eating right, exercising more and monitoring regularly can take you a long way in the right direction.
If you’re looking for a simpler way to lose weight and lower A1c, check out GlycoLeap here. It combines the latest consumer technology with expert human coaching, all from the comfort of your home.