Can You Reverse Type 2 Diabetes and Prediabetes?

If you have prediabetes or type 2 diabetes, will diet, weight loss, and exercise give you a clean bill of health?

Revers diabetes chart

A lot of people ask me if they can reverse diabetes or prediabetes. For some, the answer will be yes. But not for everyone. It’s more complicated than a simple yes or no across the board. I know. I know. We all want a simple answer, but the human body just isn’t simple. And diabetes just isn’t simple. And what makes it even harder is that I can’t say who will experience a reversal and who won’t. I do know some things about who’s the most likely person to reverse diabetes or prediabetes though. More on that in a bit.

And to be clear, I’m talking about type 2 diabetes here, not type 1. Type 1 diabetes is an autoimmune disorder, and people with type 1 diabetes require insulin by injection or pump to live.Prediabetes: A Complete Guide

The prediabetes stage is the most reversible. And your best opportunity for a lasting reversal is today. Here’s the book to give you your action plan to stop prediabetes.

To me, reversing diabetes or dialing back prediabetes means to have a long-lasting metabolic improvement without additional medications. Since type 2 diabetes and prediabetes are characterized by insulin resistance, people with diabetes or prediabetes often have high blood pressure, abnormal cholesterol and triglyceride levels, nonalcoholic fatty liver disease and other health problems, along with high blood sugar levels.

Why is Reversing Diabetes So Complicated?

We have good evidence that diet, weight management and physical activity improve all of these health concerns. But even with excellent health habits and weight loss, lots of people with prediabetes will move on to full blown diabetes. And lots of people with type 2 diabetes will still require medications for blood sugar management, blood pressure control and more.

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You might reverse diabetes, but it’s not a cure

Even if you are able to get your blood sugar level in the normal range for months or years, there’s no guarantee that lifestyle changes will keep them there indefinitely without medications. Type 2 diabetes tends to progress over time – and this isn’t the fault of the person with diabetes! Diabetes progresses because the beta-cells of the pancreas – the cells that make your body’s insulin – continue to fail. We can reverse diabetes. We can put it into remission. But we don’t have a cure for diabetes.

Check out Lower Blood Sugar Naturally with a Mediterranean Diet.

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How diabetes progresses

Before you were diagnosed with type 2 diabetes, you probably had blood sugar levels in the prediabetes range for a few years. This is true even if you weren’t diagnosed with prediabetes. Both prediabetes and type 2 diabetes are characterized by a combination of insulin resistance and loss of insulin-making ability. It’s a double whammy with some of the body’s cells stubbornly refusing to use insulin properly and the beta-cells of the pancreas unable to produce enough insulin to make up for this resistance.

diabetes pills

© Can Stock Photo / devon

The longer you’ve had diabetes, the more likely you’ll need medications because of loss of insulin-producing capacity.

I congratulate my patients with type 2 diabetes when they’re able to dial back insulin resistance enough to no longer require medications. Same for those who are able to reverse prediabetes adequately to bring numbers to the healthy level. But again, this isn’t a cure, and that’s because of loss of beta-cell function (your body’s ability to produce insulin).

Find out the Best Prediabetes Diet.

Take action today

The best day for a reversal is today! The longer you’ve had insulin resistance, the more beta-cell function you’ve probably lost. In other words, everyday the window of opportunity to reverse diabetes or prediabetes – and even to delay their progression – closes another little bit. Even if you change your lifestyle enough and even if you lose enough weight to reverse insulin resistance, you might not have enough insulin producing capacity to maintain normal blood sugar levels without the assistance of medications. And if you do, you might not always. That’s why I always insist that a reversal isn’t a cure.

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Diabetes remission

A diabetes remission is to achieve normal blood sugar levels without medications for at least 1 year. A prolonged diabetes remission is to experience the same normal blood sugar levels for 5 years. A remission or a reversal of any type usually requires some weight loss. Some people experience a diabetes remission through intensive lifestyle therapy. More often, we see remissions following weight loss surgery. But even after dropping huge amounts of weight, it’s not uncommon to see the loss of diabetes remission over time. Many people will stay in remission for a year or two, but not longer. Even those who stay in remission for 5 years are at risk of losing it.

Predictors of diabetes remission

In general, losing more weight, having had diabetes for a short time, and being in better blood sugar control are predictors of diabetes remission. This is what I meant above when I talked about that window of opportunity. The longer you’ve had diabetes, the harder it is to see a lasting reversal because of the loss of beta-cell function.

  • Take action early when your blood sugar control is better and while you have more beta-cell function
  • Lose weight if necessary
  • Lose as much as reasonably possible

Any weight loss is good

If you have overweight or obesity, losing any amount of weight is good. Dropping a few pounds can have profound benefit. In a fascinating study among people at high risk for developing type 2 diabetes, losing only 5% of body weight (10 pounds for someone starting at 200 pounds) improved insulin sensitivity in the fat, muscle and liver cells. This small weight loss also improved the function of the pancreas’s beta-cells and reduced the amount of fat in the liver. As weight loss continued first to 11% and then to 16% of starting weight, the participants experienced greater improvements. Their muscle cells became even more sensitive to insulin; they lost more fat from their livers; and the function of their beta-cells improved even more. Now that’s what I call pretty darn awesome!

Grab this 2-page schedule of diabetes appointments and tests to stay organized and healthy.

Jill Weisenberger

I'm Jill, and I believe simple changes in your mindset and health habits can bring life-changing rewards. And I don't believe in willpower. It's waaaay overrated. As a food-loving registered dietitian nutritionist, certified diabetes care and education specialist and certified health and wellness coach, I've helped thousands of people solve their food and nutrition problems. If you're looking for a better way to master this whole healthy eating/healthy living thing or if you're trying to prevent or manage diabetes or heart problems, you'll find plenty of resources right here.

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  1. Anna K. on April 6, 2019 at 8:39 am

    Thank you for this blog!!! 2 notes to you: I went from 7.1 A1C to 5.7 A1C on a strict vegan diet and living without any bread, potatoes or rice. It was difficult because it was boring! The diet made me shed a lot of weight, too; and I never was hungry! Amazing. My doc congratulated me but is keeping me on Metformin, among other things. Probably waiting to see how long I can keep this up.
    My questions to you are revolved around resistant starch; I dearly miss bread and sandwiches! Any suggestions for recipes/procedures? I’m wondering if there’s a way to make white wheat flour resistant. Would it do to simply freeze the bread after it’s baked, then just thaw and use it? Ohhhh, if it were so simple! I know this is said to be true of potatoes and rice (who likes cold rice? A cold rice salad?).
    Your thoughts would be appreciated.
    Thank you.
    Anna K.

    • Jill Weisenberger on April 8, 2019 at 9:06 am

      Congratulations on your wonderful A1C results! Freezing and other methods will not make the starch in baked bread resistant to digestion. However, I’m looking forward to seeing a new product on the market. HealthSense is a high fiber wheat flour with quite a bit of resistant starch. (FYI: I consult to the brand who makes this product). You can learn more here.

  2. Patrick Lopez on November 5, 2019 at 5:29 am

    Thanks for this article.

    • Jill Weisenberger on November 5, 2019 at 8:51 am

      My pleasure! And thanks for reading!

  3. Craig H. Smith on November 21, 2019 at 12:08 am

    I have been a prediabetic for 5 years and just crossed over with an a1c of 6.6. I do work out 5-6 times per week with 40 minutes of aerobice exercise. But my weight has stayed in the 225 +5 – 10 range during that time. I have just not done a good enough job with diet. Is it it too late? I could not be more ashamed of my failure to not lose weight with all the runway I had. Back to the a1c I was 6.3 in July and 6.6 in November. Should I be on medication? If I were to say lose 20 to 30 pounds could I get this in remission?

    • Jill Weisenberger on November 21, 2019 at 9:09 am

      Kudos to you for maintaining your exercise routine and for exploring healthy eating and weight loss. That exercise you do is so important and it helps with blood sugar control as well as a host of other health concerns. There are lots of things to know and consider when deciding about medications. That’s a conversation for you and your doctor. It is very common, however, to use metformin at the time of diagnosis because it appears to help things many years down the line. Your best opportunity for a remission is now. The longer you deal with insulin resistance and elevated blood glucose levels, the harder and less likely a remission gets. There’s so much you can do with diet. I really encourage you to make changes you can live with and to avoid highly restrictive eating plans. It’s a good idea to work with a registered dietitian nutritionist who is also a certified diabetes educator. Best wishes to you and keep us posted.

  4. Comfort Finds on April 27, 2020 at 5:41 am

    I really appreciate your way of writing. Keep up the good writing.

  5. jhon mack on July 31, 2020 at 2:07 pm

    great post! Thanks for sharing with us 🙂

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Hi there! I'm Jill, a nutrition & diabetes expert and the author of 4 books.

Jill Weisenberger

I believe simple changes in health habits can bring you life-changing rewards.

And I believe willpower is way overrated.

Right here is where you can discover the mindset and habits to stick with healthy lifestyle choices most of the time - and drop the guilt when you don't.

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