How to reverse your type 2 diabetes

Do you have type 2 diabetes, or are you at risk for diabetes? Do you have type 1 diabetes or care for someone who does? If so, then you’ve come to the right place.

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.

Many people with diabetes or prediabetes have improved their health with dietary changes. You can too! Making these changes may allow you to reduce or eliminate diabetes medication, and help you lose weight as well.1

Keep reading to see if this could work for you!


1. What is diabetes?

Simply put, diabetes is a disorder of blood sugar (glucose) and insulin.  In diabetes, something is wrong with the way a person makes or uses insulin, a pancreatic hormone that lowers blood sugar by moving it out of the bloodstream and into the body’s cells.

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 pancreas usually makes insulin but can’t use it effectively.  Because of this, the body has an increasingly hard time handling glucose in the blood.

Excess glucose in the blood is a problem because it can damage blood vessels. What’s more, other parts of the body can’t get energy from glucose because it stays in the bloodstream instead of entering the cells.

But it is not all about the glucose. Too much insulin — a hallmark of type 2 diabetes — is a problem too.

Insulin’s main job is keeping blood sugar levels within a very narrow range. It not only clears excess glucose out of the blood but also helps prevent muscle breakdown.2 Yet insulin also increases fat storage, especially when blood levels are elevated, and prevents the body from using fat for fuel.

Having too much insulin in the blood can decrease the body’s ability to use it. This is called insulin resistance. Weight gain can be one of the first signs that the body is making too much insulin and 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.3

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.4 Consistently elevated blood insulin levels 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.

Type 2 diabetes often affects people who are middle-aged or older, although it is becoming increasingly common in teenagers and young adults in poor metabolic health.5

Type 1 diabetes

Unlike people with type 2 diabetes, people who develop type 1 diabetes do not initially experience problems associated with excess insulin, such as weight gain. People with type 1 diabetes are more likely to be normal weight at diagnosis and experience rapid weight loss prior to receiving treatment.6

Since people with type 1 diabetes make little to no insulin, treatment primarily consists of administering insulin with injections. However, eating a low-carb diet can help them control their blood sugar.7

In the past, type 1 diabetes was often called juvenile-onset diabetes because it typically begins in childhood or young adulthood. But it can occur in older adults as well, often with a much more gradual onset, which is referred to as LADA (Latent Autoimmune Diabetes in Adults, sometimes called type 1.5 diabetes).8 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.9

There are also quite rare types of diabetes like MODY (Mature Onset Diabetes in the Young) and CFRD (Cystic Fibrosis Related Diabetes).10 Alzheimer’s disease is sometimes referred to as type 3 diabetes.11

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  may not notice any symptoms.

If you think you have any of the warning signs of diabetes, see your doctor.


2. About blood sugar

Our guide on 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.12

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:

  1. With clean hands, place a test strip in your blood sugar meter.
  2. Prick the side of a finger with the lancet to draw a drop of blood.
  3. Place the tip of the test strip on the drop of blood.
  4. After a few seconds, the blood sugar meter will give you a reading.

Compare your own blood sugar reading with the ranges below: 13

  • 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, find out how a low-carb diet affects blood sugar measurements.


3. Food & diabetes

People with diabetes have difficulty keeping blood sugar levels in a normal range. The blood turns “too sweet” as glucose levels rise.14

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.

Carbohydrate

Foods that turn into glucose when they are digested are called carbohydrates, or carbs. When glucose enters the bloodstream, it’s called blood glucose, or blood sugar.

Carbohydrates

Carbohydrates

The more carbohydrate eaten in a meal, the more sugar is absorbed into the bloodstream and the higher blood sugar will be.

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.15 Eating a potato can raise blood sugar as much as eating 9 teaspoons of sugar! However, it can be hard to predict for an individual as natural variability exists likely based on underling genetics and baseline insulin sensitivity.16

Protein

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.17

Fat

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. These foods probably won’t raise your blood sugar very much.18

But other foods, like donuts and French fries, are made up mostly of carbohydrate and fat. Because they’re high in carbs, these foods are likely to significantly raise your blood sugar.


4. 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.

But a picture is worth a thousand words. These are just a few of the delicious foods that don’t raise blood sugar:
foods-that-dont-raise-blood-sugar

Many people with type 2 diabetes are now choosing a diet based primarily on low-carbohydrate foods.19

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 may improve many health markers. 20

Because of these benefits and others, many doctors are recommending diets low in carbohydrates for their patients with diabetes.21

Choosing foods low in carbs 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 greatly reduced.22

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.


5. The science of diabetes reversal

In 2019, the American Diabetes Association (ADA) stated that reducing carbohydrate intake was the most effective nutritional strategy for improving blood sugar control in those with diabetes.23

Research shows that low-carb diets are a safe and effective option for treating and reversing type 2 diabetes. This body of evidence includes systematic reviews and meta-analyses of randomized controlled trials (the highest quality of evidence by our ratings.).24

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, sometimes called the “good” cholesterol.25

Last, in a non-randomized trial from Virta Health, 349 people with type 2 diabetes followed either a very-low-carb diet or a standard diet. After one year, 97% of those in the low-carb group had reduced or stopped their insulin use. Furthermore, 58% 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.26

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.


6. 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 worldwide epidemic.

In the past, 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 may lead 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.27

But now people with type 2 diabetes can hope to regain their health! Today 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, and may be able to avoid or discontinue most medications.

Normal blood sugar levels and fewer or no medications likely means no progression of disease, and no progression of complications. People with a diagnosis of type 2 diabetes may be able to live long, healthy lives, with toes, eyesight, and kidneys intact!28

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-carb diet, so your medications are adjusted safely as your blood sugars improve.

When you’re ready, here’s where to start: A low-carbohydrate diet for beginners. During your own journey, you might be inspired by some spectacular diabetes success stories.

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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  1. The 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 [non-randomized trial; weak evidence]

  2. Diabetologia 2016: Role of insulin in the regulation of human skeletal muscle protein synthesis and breakdown: a systematic review and meta-analysis [systematic review; strong evidence]

  3. Centers for Disease Control and Prevention: Type 2 Diabetes

  4. Diabetes Care 2012: Diabetes: have we got it all wrong? [mechanism article; ungraded]

  5. This is based on statistics from the CDC.

  6. Pediatric Diabetes 2005: Clinical presentation of type 1 diabetes. [observational study, weak evidence]

  7. Diabetes, Obesity and Metabolism 2017: Short-term effects of a low-carbohydrate diet on glycaemic variables and cardiovascular risk markers in patients with type 1 diabetes: A randomized open-label crossover trial [moderate evidence]

    Pediatrics 2018: Management of type 1 diabetes with a very low-carbohydrate diet [observational study; very weak evidence]

    Diabetology & Metabolic Syndrome 2012: Low-carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit [non-controlled trial; weak evidence]

  8. Nature Reviews. Endocrinology 2017: Adult-onset autoimmune diabetes: current knowledge and implications for management [overview article; ungraded]

  9. The Lancet 2009: Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis [overview article; ungraded]

  10. Journal of Nurse Practitioners 2019: The Diagnosis and management of atypical types of diabetes [randomized trial; moderate evidence]

  11. Journal of Diabetes Science and Technology 2008: Alzheimer’s Disease is type 3 diabetes — evidence reviewed [overview article; ungraded]

  12. Diet Doctor will not benefit from your purchases. We do not show ads, use any affiliate links, sell products or take money from industry. Instead we’re funded by the people, via our optional membership. Learn more

  13. These definitions are based on the ADA guidelines

  14. In fact, 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, easily accessible blood meters instead.

  15. Studies have consistently shown that all digestible carbs have a much greater impact on blood sugar levels than protein or fat:

    Diabetes Care 2004: Dietary carbohydrate (amount and type) in the prevention and management of diabetes [overview article; ungraded]

  16. PLOS Biology 2018: Glucotypes reveal new patterns of glucose dysregulation [observational study, weak evidence]

  17. Diabetes 2004: Effect of a high-protein, low-carbohydrate diet on blood glucose control in people with type 2 diabetes [randomized trial; moderate evidence]

    American Jopurnal of Clinical Nutrition 2003: An increase in dietary protein improves the blood glucose response in persons with type 2 diabetes [randomized trial; moderate evidence]

  18. The trials included in this review of RCTs did not restrict protein or fat intake and showed significant improvement in blood glucose levels and metabolic health.

    BMJ Open Diabetes Research and Care: Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes [strong evidence]

  19. Here are some amazing stories from some of those people: Diabetes success stories

  20. This is based on clinical experience of low-carb practitioners and was unanimously agreed upon by our low-carb expert panel[weak evidence]. You can learn more about our panel here. However, there is also substantial scientific support for these benefits, as we will describe below.

  21. Medical doctors recommending a low-carb or ketogenic diet

  22. Diabetes Therapy 2018: Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study [weak evidence]

  23. Diabetes Care 2019: Nutrition therapy for adults with diabetes or prediabetes: a consensus report [overview article; ungraded]

  24. Diabetes Research and Clinical Practice 2018: Effect of dietary carbohydrate restriction on glycemic control in adults with diabetes: A systematic review and meta-analysis [strong evidence]

    BMJ Open Diabetes Research and Care 2017: Systematic review and meta-analysis of dietary carbohydrate restriction in patients with type 2 diabetes [strong evidence]

    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]

  25. 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]

  26. Diabetes Therapy 2018: Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study [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 [weak evidence]

  27. Journal of Diabetes Research 2017: Complications of diabetes 2017 [overview article; ungraded]

  28. Long term studies of aggressive glucose control show benefits for microvascular complications, such as kidney and eye disease, but have not shown benefit for “macrovascular disease” such as heart attacks or even for all cause mortality. One hypothesis is that the majority of the treatments studied increase insulin. This can increase the risk of dangerous hypoglycemia, but it also does not alter the underlying cause of the diabetes. Low-carb nutritional therapy, however, lowers both blood sugar and insulin. Therefore there is ample reason to believe it will have beneficial long term cardiovascular and mortality effects similar to the drug studies in SGLT2 inhibitors.

    NEJM 1993: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus [randomized trial; moderate evidence]

    NEJM 2008: Effects of intensive glucose lowering in type 2 diabetes [randomized trial; moderate evidence]

    NEJM 2015: Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. [randomized trial; moderate evidence]

    NEJM 2019: Dapagliflozin and cardiovascular outcomes in type 2 diabetes. [randomized trial; moderate evidence]