Diabetes is a chronic disease that affects how the body regulates blood sugar, or glucose, levels. With diabetes, the body either cannot produce enough insulin or cannot properly use the insulin it produces, leading to high blood sugar levels. Over time, uncontrolled high blood sugar can cause serious complications like heart disease, stroke, kidney disease, eye problems and nerve damage. There are two main types of diabetes:
Type 1 Diabetes
Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is an autoimmune disease in which the body’s immune system attacks and destroys insulin-producing cells in the pancreas. This means people with type 1 diabetes must take insulin injections to survive. Type 1 diabetes usually develops in children, teenagers and young adults, though it can develop at any age. There is no way to prevent type 1 diabetes.
Type 2 Diabetes
Type 2 diabetes, formerly called adult-onset diabetes or non-insulin dependent diabetes, is the most common form of diabetes, accounting for 90-95% of all diabetes cases. With type 2 diabetes, the body still produces insulin but cannot use it effectively. This is known as insulin resistance. Type 2 diabetes tends to develop later in life, though it is increasingly being diagnosed in children, teens and younger adults due to rising obesity rates. Type 2 diabetes is often preventable through lifestyle changes like diet, exercise and weight loss.
How Does Exercise Help With Diabetes?
Exercise has a number of benefits for people with diabetes. Some of the key ways exercise helps include:
- Improves insulin sensitivity – Exercise makes the muscles more sensitive to insulin. This enables the body to use insulin more efficiently to regulate blood sugar.
- Lowers blood sugar – Exercise causes muscles to use glucose for energy, taking it out of the bloodstream and lowering blood sugar levels.
- Reduces risk factors – Exercise helps with weight loss and reduces unhealthy cholesterol and triglyceride levels, lowering cardiovascular disease risk.
- Boosts energy – Exercise improves circulation and oxygen delivery throughout the body, combating fatigue.
- Relieves stress – Exercise releases endorphins that make you feel good and reduces stress hormones like cortisol.
For these reasons, exercise is recommended as a key component of any diabetes management plan. But can exercise actually reverse diabetes? Let’s take a closer look.
Can Exercise Reverse Type 1 Diabetes?
Type 1 diabetes is an autoimmune disease caused by destruction of the insulin-producing beta cells in the pancreas. Because this cell loss is irreversible, type 1 diabetes cannot be cured through exercise or lifestyle changes alone. People with type 1 diabetes will always require insulin administration to survive.
However, exercise still provides significant benefits for people with type 1 diabetes:
- Improves blood sugar control – Exercise helps the body use insulin more efficiently, leading to better blood sugar management.
- Reduces cardiovascular risk – Exercise helps lower triglycerides, bad cholesterol and blood pressure.
- Boosts energy – Exercise enhances circulation and increases stamina.
- Helps maintain a healthy weight – Exercise burns calories and makes weight management easier.
In addition, some emerging research suggests exercise may help preserve remaining beta cell function in newly diagnosed cases of type 1 diabetes. So while exercise cannot reverse or cure type 1 diabetes, it is a vital part of managing the disease.
Conclusion for Type 1 Diabetes
While exercise provides significant benefits, it cannot reverse or cure type 1 diabetes because the loss of insulin-producing cells is irreversible. However, exercise remains a critical part of the treatment plan to help optimize blood sugar control, reduce cardiovascular risk factors, boost energy and maintain a healthy body weight.
Can Exercise Reverse Type 2 Diabetes?
In contrast to type 1 diabetes, studies show exercise can effectively reverse type 2 diabetes in some cases. Exercise improves insulin sensitivity, lowers blood sugar levels and helps with sustainable weight loss – all of which can put type 2 diabetes into remission.
A major 2018 study on type 2 diabetes remission published in The BMJ looked at the effects of an intensive weight loss program among people recently diagnosed with type 2 diabetes in England. Participants in the intervention group followed a very low-calorie liquid diet, stepped food reintroduction and long-term weight loss maintenance program. They also received exercise support, glucose monitoring and nurse coaching.
After one year, 68% of the intervention group achieved diabetes remission defined as an HbA1c level below 6.5% without medication, compared to just 4% in the control group receiving standard care. At two years, 64% remained in remission. The intensive lifestyle program led to an average weight loss of 33 lbs at 12 months and 30 lbs at 24 months.
Other studies also show exercise can reverse diabetes progression:
- A meta-analysis published in Medicine & Science in Sports & Exercise found structured exercise interventions improved HbA1c and caused remission in 27% of people with type 2 diabetes.
- A study in Diabetologia found a 12-week program of alternating aerobic and resistance exercise improved beta cell function and led to diabetes remission in 36% of participants.
However, reversing diabetes through exercise and lifestyle changes may be more achievable for some patients compared to others. Factors include:
- Time since diagnosis – Early intervention improves remission chances.
- Weight – Those with less excess weight typically lose more easily.
- Fitness level – More fit individuals adapt to exercise better.
- Genetics and ethnicity – Remission rates are lower among certain ethnicities.
- Pancreatic function – Individuals with more remaining beta cell function respond better.
- Adherence – Following the lifestyle program diligently improves success.
Conclusion for Type 2 Diabetes
Research shows that for some patients who are newly diagnosed and take action quickly, regular exercise along with diet changes and weight loss can reverse type 2 diabetes by restoring beta cell function and normalizing blood sugars without medication. However, reversal is more achievable for certain patients based on individual characteristics.
Best Types of Exercise to Reverse Diabetes
To reverse diabetes, experts recommend getting 150 minutes per week of moderate-intensity aerobic activity, such as brisk walking, cycling or swimming. Muscle-strengthening exercises are also encouraged 2-3 times weekly. Combining different types of exercise can help maximize results:
Aerobic Exercise
- Brisk walking
- Jogging
- Biking
- Swimming
- Water aerobics
- Dancing
- Rowing
Aerobic exercise causes the muscles to use glucose for fuel, lowering blood sugar levels. It also improves cardiovascular fitness. Opt for aerobic activities you enjoy and mix it up to prevent boredom.
Resistance Training
- Bodyweight exercises like squats, lunges and pushups
- Free weights like dumbbells or kettlebells
- Weight machines
- Resistance bands
Resistance training builds muscle mass which boosts metabolism and increases insulin sensitivity. For best results, work all major muscle groups including legs, hips, back, chest, abdomen, shoulders and arms.
High-Intensity Interval Training (HIIT)
HIIT involves short, intense bursts of exercise alternated with recovery periods. Types of HIIT include:
- Sprinting or cycling intervals
- Bodyweight circuits
- Tabata workouts
- Jumping rope routines
Research suggests HIIT may improve insulin sensitivity and blood sugar control more than moderate continuous exercise. However, HIIT may not be appropriate for all diabetes patients.
Yoga and Tai Chi
Gentle practices like yoga, tai chi and Pilates can build core strength, balance, flexibility and posture. Yoga has been shown to lower blood sugar and A1C levels. These activities also reduce stress.
How Much Exercise is Needed to Reverse Diabetes?
Most studies on type 2 diabetes reversal utilize 150-175 minutes per week of moderate exercise such as brisk walking. This lines up with general activity guidelines recommending adults get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise weekly, plus muscle-strengthening activities at least 2 days per week.
Spreading activity out during the week is ideal for maintaining stable blood sugar levels. For sustained diabetes remission, maintaining consistent physical activity and avoiding weight regain are critical. It also helps to build activity into daily routines – taking stairs, walking breaks, gardening, housework, etc.
Here are examples of weekly exercise plans for diabetes reversal:
| Monday | 30 minute walk |
|---|---|
| Tuesday | 60 minute cycling class |
| Wednesday | 30 minute walk |
| Thursday | Lower body resistance workout |
| Friday | 30 minute walk |
| Saturday | Upper body resistance workout |
| Sunday | Rest day or light activity like yoga |
This totals 150 minutes of aerobic activity and about 60 minutes resistance training. For greater benefits, aim for 200+ minutes of moderate activity or about 25-35 miles of brisk walking or running per week.
Other Lifestyle Changes to Reverse Diabetes
While exercise is key, other healthy lifestyle changes also help reverse diabetes by promoting weight loss and improving insulin resistance:
Weight Loss
Carrying excess weight strains the body’s ability to use insulin efficiently. Losing a modest 5-10% of body weight can improve blood sugar levels if sustained over time. A weight loss of 10-15% can put diabetes into remission. Slow, steady weight loss of 1-2 pounds per week through diet and exercise is recommended.
Healthy Eating
Choose whole, minimally processed foods like fruits, vegetables, whole grains, lean proteins, healthy fats from nuts, seeds and olive oil. Limit sugary drinks, refined carbs, fried foods and alcohol. Working with a dietitian can help optimize nutrition for diabetes reversal.
Quit Smoking
Smoking worsens insulin resistance and complicates diabetes management. Quitting improves blood sugar control and reduces cardiovascular risk.
Stress Management
Chronic stress leads to higher cortisol levels, which impairs blood sugar regulation. Try relaxation techniques like meditation, yoga, deep breathing and massage for better diabetes control.
Adequate Sleep
Not getting enough sleep can disrupt metabolism and hormone levels in a way that increases diabetes risk. Aim for 7-9 hours of quality sleep per night.
Challenges of Reversing Diabetes
While reversing diabetes through lifestyle changes is possible, doing so can be extremely challenging. Hurdles patients may face include:
- Weight loss resistance – Losing weight with diet and exercise alone can be difficult, especially for those with more weight to lose.
- Lack of adherence – Maintaining lifestyle changes requires tremendous commitment most find difficult.
- Life stressors – Major life events like job changes or loss, divorce, moves can derail progress.
- Metabolic adaptations – The body adapts to weight loss by lowering metabolism and increasing appetite.
- Cost – Healthy foods, gym memberships and programs can be expensive.
- Limited access – Some people lack access to nutritious foods, safe spaces to exercise, and other resources needed to facilitate lifestyle changes.
For these reasons, reversing diabetes through lifestyle alone remains uncommon. While sustained lifestyle change can lead to remission, most people require anti-diabetic medication even if diagnosed early. Still, the right lifestyle modifications can potentially enable some patients to achieve remission or reduce medication needs.
The Role of Bariatric Surgery in Diabetes Remission
For patients who struggle to lose enough weight through diet and exercise alone, bariatric or metabolic surgery may be an option to bring about diabetes remission. Research shows certain bariatric procedures can normalize blood glucose levels in both obese and non-obese diabetic patients.
A major study on bariatric surgery for diabetes remission was the STAMPEDE trial, published in the New England Journal of Medicine. It found that gastric bypass or sleeve gastrectomy surgery led to superior diabetes remission and control compared to intensive medical therapy alone.
- At 5 years, gastric bypass led to 52% diabetes remission versus 16% with medical therapy alone.
- Sleeve gastrectomy led to 35% remission at 5 years versus 12% with medical therapy alone.
Other studies also confirm bariatric surgery’s effectiveness for achieving long-term diabetes remission not otherwise obtainable for many through lifestyle measures alone. However, it does involve risks and is generally only recommended for those with:
- Severe obesity (BMI 35-40+)
- Uncontrolled diabetes despite medication compliance
- Inability to achieve remission goals through other means.
Conclusion on Bariatric Surgery
For people struggling with severe obesity and uncontrolled diabetes, bariatric surgery coupled with lifestyle changes may offer the best chance of permanently reversing diabetes when intensive lifestyle measures alone have failed. However, it does come with short and long-term risks that must be carefully weighed.
Maintaining Diabetes Remission Long-Term
The greatest challenge in reversing type 2 diabetes is maintaining remission over the long term. Lifestyle habits must stay consistent to keep weight off and blood sugars normalized. Tips for sustaining diabetes remission include:
- Weigh yourself weekly – Catch any weight regain early.
- Monitor blood sugar – Check periodically to catch increases.
- Continue exercise – Make it a regular lifelong habit.
- Eat consistent meals – Don’t skip meals, especially breakfast.
- Get support – Enlist family, friends, doctors to cheer you on.
- Stay positive – Focus on accomplishments and don’t get discouraged.
- Plan for setbacks – Have a plan to get back on track if you veer off.
Even with diligence, diabetes remission can be temporary. Some regression of beta cell function is common over time. If blood sugars creep up again, medication and lifestyle adjustment may be needed. But regularly exercising and keeping weight down can help preserve remission for years.
Conclusion
In summary, exercise cannot reverse or cure type 1 diabetes due to permanent loss of insulin producing cells. However, regular exercise provides substantial benefits for blood sugar management, weight control, cardiovascular health and wellbeing. For some patients with type 2 diabetes, studies show early intervention with structured exercise programs combined with diet changes can put diabetes into remission by restoring pancreatic function, particularly for those with less excess weight to lose. However, maintaining long-term lifestyle changes to sustain remission can prove challenging. Bariatric surgery may offer an additional option for achieving diabetes reversal when intensive lifestyle measures alone fail. Overall, while difficult, regular exercise along with other healthy lifestyle habits provide the best shot at reversing diabetes progression and potentially putting type 2 diabetes into remission if implemented early and maintained diligently over the long term.
