How to reverse your type 2 diabetes
This guide gives you an overview of what you need to know about diabetes. Our other guides can teach you more about the symptoms of diabetes, as well as provide specific information about type 2 diabetes and type 1 diabetes.
We also have a practical guide about the best foods to control diabetes.
Many people with diabetes or prediabetes have improved their health with dietary changes. You can too! This may mean that you can reduce or eliminate diabetes medication, and these same dietary changes may help you lose weight as well.
Keep reading to see if this could work for you!
2. What is diabetes?
Simply put, diabetes is a disorder of blood sugar and insulin. The reason that a person develops high blood sugar depends on what type of diabetes that a person has. However, all types of diabetes indicate that something has gone wrong with the way a person makes or uses insulin.
Type 1 diabetes results when, for autoimmune or other unknown reasons, the pancreas becomes damaged and fails to produce insulin.
In type 2 diabetes, the body usually does make insulin, but can’t use it effectively. Then the body has an increasingly hard time handling sugar in the blood.
Too much sugar in the blood is a problem because the sugar molecule in your blood, called glucose, damages blood vessels when there is too much of it. At the same time, other parts of the body can’t get energy from glucose because the glucose stays in the bloodstream and doesn’t enter other cells. Over time, this situation can harm the body in many ways and cause serious complications.
Too little insulin is a life-threatening condition, but too much insulin, a hallmark of type 2 diabetes, is a problem too. Insulin is a hormone made by the pancreas that lowers blood sugar by moving sugar out of the bloodstream and into the body’s cells.
Insulin’s primary job is to keep blood sugar levels within a very narrow range. Insulin not only helps clear the excess glucose out of the blood, it also helps prevent muscle breakdown.1 However, insulin also increases fat storage, especially when blood levels are elevated, and prevents the body from using fat for fuel.
Over time, too much insulin in the blood decreases the body’s ability to use insulin. This is called insulin resistance. Weight gain can be one of the first signs that the body is making too much insulin and is becoming insulin resistant. Diet and other lifestyle changes can help reverse insulin resistance and its associated weight gain, which may help prevent diabetes.
To learn more about diabetes, click here:
Types of diabetes
There are different kinds of diabetes, but all involve having too much sugar in the blood because the body is not making or using insulin effectively.
Type 2 diabetes
Type 2 diabetes is by far the most common form of diabetes, accounting for over 90% of all cases.[note]Centers for Disease Control and Prevention: Type 2 Diabetes [/note]
Type 2 diabetes begins when an individual makes more insulin than the body can handle. When people are diagnosed with type 2 diabetes, they often have ten times more insulin in their bodies than normal.[note]Diabetes Care 2012: Diabetes: have we got it all wrong? [mechanism article; ungraded][/note] When insulin levels in your blood stay high for long periods of time, this can cause weight gain and other symptoms of insulin resistance.
Over time, the pancreas can no longer make enough insulin to keep blood sugar levels in check — even though it may still be making a lot! That’s because cells have become increasingly resistant to insulin’s effect.. When this happens, blood sugar levels start to rise, and a person may be diagnosed with prediabetes or type 2 diabetes. When this happens, a diet that limits the foods that raise blood sugar the most can help.
Type 2 diabetes often affects people who are middle-aged or older, although it is becoming an increasing problem for teenagers and young adults in poor metabolic health. It’s not uncommon for the affected person to also have high blood pressure and other health problems.
Type 1 diabetes
Unlike people with type 2 diabetes, people who develop type 1 diabetes do not often experience problems associated with excess insulin, such as weight gain. People with type 1 diabetes are, in fact, much more likely to be normal weight at diagnosis and experience rapid weight loss prior to receiving treatment.
Since people with type 1 diabetes make little to no insulin, treatment primarily consists of administering insulin with injections. In addition, a diet that doesn’t raise blood sugar can help people with type 1 diabetes achieve and maintain stable, normal blood sugar levels.
In the past, type 1 diabetes was often called juvenile-onset diabetes because it typically begins in childhood or when someone is a young adult. However, it can occur in older adults as well, often with a more gradual onset, which is referred to as LADA (Latent Autoimmune Diabetes in Adults, sometimes called type 1.5 diabetes). Regardless of one’s age at diagnosis, its effects last a lifetime.
Other types of diabetes
Sometimes a diagnosis of diabetes doesn’t fit neatly into the categories of type 1 or type 2. Some overweight adults develop type 1 diabetes, and thin people can develop type 2 diabetes. Gestational diabetes is a special case of type 2 diabetes that happens temporarily during pregnancy, although having gestational diabetes can make it more likely that you will develop type 2 diabetes later in life.[note]The Lancet 2009: Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis [overview article; ungraded][/note] There are also quite rare types of diabetes like MODY (Mature Onset Diabetes in the Young) and CFRD (Cystic Fibrosis Related Diabetes). Alzheimer’s disease is sometimes referred to as type 3 diabetes.[note] Journal of Diabetes Science and Technology 2008: Alzheimer’s Disease is type 3 diabetes — evidence reviewed [overview article; ungraded][/note]
Common symptoms of diabetes
- Increased thirst and urination
- Severe fatigue
- Feeling hungrier than usual
- Unexplained weight loss
- Delayed healing of injuries
- Blurred vision
- Numbness and tingling in hands, feet or toes
- Dark patches of skin
- Skin rashes and lesions
- Yeast and urinary tract infections (women)
- Erectile dysfunction (men)
For more details about these conditions, see our guide to symptoms of diabetes. However, please note that with prediabetes and early stages of type 2 diabetes, you often don’t notice anything.
If you think you have any of the warning signs of diabetes, see your doctor.
3. About blood sugar
Our guide, “What you need to know about blood sugar”, can help you learn more about both high and low blood sugar. This guide to diabetes focuses specifically on the high blood sugar levels that occur in diabetes.
How do you know if you have too much sugar in your blood? If you don’t know already, it’s simple to test in a few seconds, either in your doctor’s office or with your own inexpensive blood glucose meter.2
If you are testing your blood sugar at home, read and follow the directions that come with your blood sugar meter. For most meters, the general procedure goes like this:
- With clean hands, place a test strip in your blood sugar meter.
- Prick the side of a finger with the lancet to draw a drop of blood.
- Place the tip of the test strip on the drop of blood.
- After a few seconds, the blood sugar meter will give you a reading.
Compare your own blood sugar reading with the ranges below: 3
- Normal blood sugar: Less than 100 mg/dL (5.6 mmol/L ) after fasting overnight, and up to 140 mg/dL (7.8 mmol/L ) after a meal
- Prediabetes: Between 100-125 mg/dL (5.6-7.0 mmol/L) after fasting overnight
- Diabetes: 126 mg/dL (7.0 mmol/L) or higher after fasting overnight, or higher than 200 mg/dL (11.1 mmol/L) after a meal
Keep in mind that a single blood sugar reading isn’t enough for a diagnosis of diabetes. Your doctor can perform further testing to confirm whether you have diabetes or prediabetes.
If you are already on a low-carbohydrate diet and you are concerned about the measurements you’re getting, see “How a low-carb diet affects blood sugar measurements.”
4. Food & diabetes
People with diabetes have difficulty keeping blood sugar levels in a normal range. The blood turns “too sweet” as glucose levels rise.4
Sugar in your blood comes from two places: your liver and the food that you eat. You can’t do much to control the amount of sugar your liver makes, but you can control the foods you eat.
Foods are made up of three broad categories known as macronutrients (major nutrients): carbohydrate, protein, and fat. Many foods are a combination of two or all three macronutrients, but we often group foods according to whether they are mostly carbohydrate, protein, or fat.
Foods that turn into glucose when they are digested are called carbohydrates. When glucose enters the bloodstream, it’s called blood sugar.
Although very few people would agree that sugary foods are good for you, some foods that we think of as “healthy” — such as fruit — actually have a lot of sugar. And many people don’t know that starchy foods — such as bread, rice, pasta, and potatoes — quickly turn to sugar when you digest them. Eating a potato can raise blood sugar as much as eating 9 teaspoons of sugar!
Protein foods are foods like eggs, chicken, steak, and tofu. Although different people have different responses to some protein foods, consuming moderate amounts of protein at a meal generally has little effect on blood sugar.
Dietary fat has very little effect on blood sugar. However, we seldom eat fat all by itself. Some foods, like cheese, are made up of mostly protein and fat. Those foods are not likely to raise your blood sugar very much. But some foods, like donuts and French fries, are made up mostly of carbohydrate and fat. Because of their carbohydrate content, these kinds of foods are likely to raise your blood sugar.
5. How to improve blood sugar
What happens if you remove foods that raise your blood sugar from your diet? Is there anything good left to eat? We think so. In fact, we have a whole guide on “The best foods to control diabetes.”
They often notice that, starting with the first meal, their blood sugar improves. The need for medications, especially insulin, is usually dramatically reduced. Substantial weight loss often follows. Finally, they usually feel better, have more energy and alertness, and can improve many health markers. 6
Because of these benefits and others, many doctors are recommending diets low in carbohydrates for their patients with diabetes.7
Choosing foods low in carbohydrates is a safe and easy way to help you control your blood sugar. However, if you are taking medications for your diabetes, you must work with your healthcare provider to adjust your medications when you change your diet. Choosing a diet made up of food with fewer sugars and starches means that your blood sugar levels may improve quickly. The need for medications, especially insulin, may be dramatically reduced.
If you are looking for a doctor who will work with you to control your diabetes with a change in diet, our map may help you find one.
6. The science of diabetes reversal
Research shows that low-carb diets are a safe and effective option for treating and reversing type 2 diabetes. This body of evidence includes meta-analyses of randomized controlled trials (the highest quality of evidence by our ratings.).9
A meta-analysis from 2017 found that low-carb diets reduced the need for medication and also improved health markers in people with type 2 diabetes. These included reductions in hemoglobin A1c (HbA1c), triglycerides and blood pressure and increases in high-density lipoprotein (HDL) cholesterol, the “good” cholesterol.10
Last, a non-randomized trial of a ketogenic, low-carb diet from Virta Health involving about 330 people with type 2 diabetes, found that, at the one-year mark, 97 percent of patients had reduced or stopped their insulin use. Furthermore, 58 percent no longer had a diabetes diagnosis, meaning they had put their disease into remission. These results remained remarkable up to the two-year mark as well.11 This evidence disproves the idea that type 2 diabetes is a progressive and irreversible disease. Instead, it clearly demonstrate that it is a treatable disease when an effective lifestyle intervention is used. Read more
7. A message of hope
As recently as 50 years ago, type 2 diabetes was extremely rare. Now, around the world, the number of people with diabetes is increasing incredibly rapidly and is heading towards 500 million. This is a world-wide epidemic.
In the past, those affected by the most common form of diabetes, type 2, were told that they would never regain their health. Type 2 diabetes was thought to be a progressive disease with no hope for reversal or remission. People were — and sometimes still are — taught to “manage” type 2 diabetes, rather than to try to reverse their high blood sugars.
Unfortunately, “managing” type 2 diabetes often leads to an increase in medications and to serious complications: impaired vision, damaged kidneys, wounds that won’t heal, and decreased cognitive function. In many cases, these complications lead to blindness, kidney failure and dialysis, amputation, dementia, and death.
But now people with type 2 diabetes can hope to regain their health! Now we know that the hallmarks of type 2 diabetes — high blood sugar and high insulin — can often be reversed. People don’t just have to “manage” their diabetes as it progresses. Instead, they can often lower their blood sugar to normal levels with diet alone. This also means they may be able to avoid or discontinue most medications.12
Normal blood sugar levels and fewer or no medications means no progression of disease, and no progression of disease means no complications. People with a diagnosis of type 2 diabetes may be able to live long, healthy lives, with toes, eyesight, and kidneys intact!
If you are not on any medications, you can start your journey back to health today. If you are on medications for diabetes or for other conditions, consult your doctor before beginning any lifestyle change, such as a low-carbohydrate diet, so that your medications are adjusted safely as your blood sugars improve.
If you want to learn more about how you can improve your health and the health of your family, start here by keeping up with the latest news from Diet Doctor.
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In fact, as medical students we were taught that prior to blood glucose tests being available, doctors would sometimes (hopefully not too often) diagnose diabetes by tasting sweet urine. Thankfully, we now have reliable blood meters instead. ↩
This is based on clinical experience of low-carb practitioners and was unanimously agreed upon by our low-carb expert panel. You can learn more about our panel here [weak evidence]. However, there is also substantial scientific support for these benefits, as we will describe below. ↩
Diabetes, Obesity & Metabolism 2019: An evidence‐based approach to developing low‐carbohydrate diets for type 2 diabetes management: a systematic review of interventions and methods [strong evidence] ↩
European Journal of Clinical Nutrition 2017: The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials [strong evidence] ↩
Frontiers in Endocrinology 2019: Long-term effects of a novel continuous remote care intervention including nutritional ketosis for the management of type 2 diabetes: A 2-year non-randomized clinical trial [weak evidence] ↩
Frontiers in Endocrinology 2019: Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-Year Non-randomized Clinical Trial [non-randomized study; weak evidence] ↩