Diabetes is a chronic disease that affects how the body processes blood glucose, also called blood sugar. In early stages, diabetes may be reversible with lifestyle changes and treatment. Here, we examine if diabetes is reversible when caught early.
What is diabetes?
Diabetes occurs when the body cannot properly use or store glucose from food. This leads to high blood glucose levels. There are three main types of diabetes:
- Type 1 diabetes – The body does not produce insulin due to autoimmune destruction of pancreatic beta cells. It often begins in childhood.
- Type 2 diabetes – The body does not produce enough insulin or cannot properly use it. It accounts for 90-95% of diabetes cases.
- Gestational diabetes – High blood glucose levels that develop during pregnancy. It usually resolves after delivery.
In early stages, the signs of diabetes may not be severe. However, over time, elevated blood glucose causes serious complications if left untreated. This can damage the heart, blood vessels, eyes, kidneys, and nerves.
Is diabetes curable?
Currently, there is no cure for diabetes. However, type 2 diabetes can go into remission with weight loss and lifestyle changes. Remission means blood glucose levels are normal without needing medications. But diabetes can recur if weight and old habits return. For type 1 diabetes, the destruction of insulin-producing cells is irreversible. So it requires lifelong insulin therapy.
Can you reverse diabetes in the early stages?
Reversing diabetes means restoring normal blood glucose levels without medication. This may be possible in prediabetes or recently diagnosed diabetes.
Prediabetes
Prediabetes means blood sugar levels are higher than normal but not high enough for a diabetes diagnosis. Up to 70% of people with prediabetes can avoid developing diabetes through:
- Weight loss of 5-10% of body weight
- 150 minutes per week of moderate physical activity
- Healthy low-carb meal planning
Losing weight and building muscle helps the body use insulin properly again. Exercise also improves insulin sensitivity. Limiting carbohydrate intake to complex carbs like whole grains helps control blood sugar spikes. Taking these steps can bring blood glucose back to normal ranges.
Recently diagnosed diabetes
Within the first 5 years of a type 2 diabetes diagnosis, remission is possible. A diabetes remission program involves:
- Very low calorie diet of 800 calories daily for 3-5 months
- Gradual reintroduction of healthy foods
- Increased physical activity
- Medication if needed
- Education on maintaining remission
Studies on intensive weight management programs show remission rates between 30-60% one year after completion. The more weight lost, the higher the success rates. However, there is a risk of diabetes returning if weight is regained.
For type 1 diabetes diagnosed within the past 3 months, some residual insulin production may remain. With immune-suppressing medications, it may be possible to preserve these beta cells. This can lead to a honeymoon period of normal or near-normal blood glucose lasting months to years. But most patients still require insulin long-term.
Role of early diagnosis and treatment
The sooner diabetes is caught, the better the chances of reversal. Undiagnosed diabetes can cause irreversible beta cell loss over time. So screening those at risk allows early intervention.
Prediabetes screening should be done for those who are:
- Overweight or obese
- Over 45 years old
- Physically inactive
- Have family history of type 2 diabetes
Early signs of type 1 diabetes to watch for are increased thirst, frequent urination, fatigue, and unexplained weight loss. Catching it within 3 months of symptom onset provides the best opportunity to preserve some insulin production.
Aggressive lowering of blood glucose levels in the early years after diagnosis can help prolong beta cell function as well. This retains the body’s ability to produce insulin naturally for as long as possible.
Lifestyle changes for diabetes reversal
Making significant but sustainable lifestyle modifications is key to successfully reversing diabetes. Here are some tips:
Weight loss
- Aim for slow, steady weight loss of 1-2 pounds per week
- Choose a moderate calorie-reduced diet full of vegetables, fruits, whole grains, beans, lentils, nuts, seeds, lean proteins
- Be consistent with portion control and meal planning
Physical activity
- Get at least 150 minutes per week of brisk walking, cycling, swimming, strength training
- Minimize sitting time by taking movement breaks every 30 minutes
Stress management
- Make time for relaxing activities like yoga, meditation, deep breathing
- Improve sleep quantity and quality
- Seek support from loved ones
Blood sugar monitoring
- Check fasting and post-meal glucose readings
- Use a continuous glucose monitor if possible
- Learn how different foods impact your blood sugar
Medication adherence
- Take all medications as directed
- Monitor for side effects
- Stay current on eye, foot, kidney, and heart health exams
Making step-wise, maintainable food, fitness, and lifestyle changes maximizes the chances of safely lowering blood glucose levels long-term.
Medical interventions
Certain medications and procedures can help restore normal glucose metabolism in early diabetes:
Medications
- Metformin – First-line diabetes medication that reduces glucose production by the liver and improves insulin sensitivity.
- GLP-1 agonists – Injectable agents that stimulate insulin release and suppress appetite.
- SGLT2 inhibitors – Newer oral medications that remove excess glucose through the urine.
- Insulin – May be used short-term to quickly normalize blood glucose in early type 2 diabetes.
Bariatric surgery
Weight loss surgery like gastric bypass and sleeve gastrectomy can help diabetic patients achieve remission. Surgery restricts the stomach and changes gut hormone signals. This reduces appetite, lowers blood sugar, and improves insulin sensitivity.
Pancreas transplantation
For patients with type 1 diabetes, transplanting a healthy pancreas provides functioning beta cells again. This can make the patient insulin-independent. However, lifelong immunosuppression is required.
When combined with lifestyle interventions, medications and procedures can help promote long-term diabetes reversal by preserving and restoring the body’s ability to regulate glucose normally.
Maintaining diabetes reversal
The biggest challenge in reversing diabetes is keeping blood glucose normal long-term. Relapse is common if old habits return. To maintain remission, it is essential to:
- Continue regular activity and healthy eating
- Stick to regular monitoring and screening
- Keep body weight stable
- Take medications and supplements as directed
- Manage stress well
Ongoing healthcare, social support, education, and motivation help make these lifestyle changes last. Even if reversal is not permanent, any periods off medication are beneficial.
Limitations of reversal
Reversing diabetes has limitations:
- Not all patients can achieve or maintain remission
- Some reversal therapies have side effects or surgery risks
- Islet transplantation is still experimental with unreliable long-term success
- Blood glucose may not normalize in late-stage disease
- Vascular and nerve complications may persist despite glucose control
Genetics and other factors affect reversibility. The longer someone has lived with uncontrolled diabetes, the less reversibility is possible. For many, the goal becomes optimally managing diabetes rather than curing it.
Takeaway
Catching diabetes early maximizes the potential for remission through weight loss, lifestyle changes, medications, and surgery. Type 2 diabetes is more reversible than type 1. However, reversal requires dedicated effort, medical support, and consistent behavior changes. Periodic monitoring and prevention care are still needed to detect and manage complications or recurrence.
While diabetes cannot be cured, remission provides huge benefits by avoiding or delaying complications. Even if temporary, reversing diabetes at any stage eases symptom burden and reduces associated health risks. For optimal outcomes, early recognition and treatment of diabetes is key. Ongoing research brings hope for more options to someday restore normal glucose control in diabetic patients.
