By Dr. Suneil Koliwad, Senior Yes Health Advisor
We’ve all heard the stories, whether from friends or the news: diabetes might be reversible. Someone who once had to manage their blood sugar with pills or insulin shots, now doesn’t. But how applicable are these individual triumphs to the average American, and most importantly, if people have successfully kicked diabetes to the curb, how did they do it?
The medical and research communities typically view diabetes as a continuum, beginning at an early stage with prediabetes, progressing to full-blown type 2 diabetes (if no healthy life style changes are made) and ultimately leading to insulin dependency for those whose pancreas begins to fail. We encourage people with prediabetes or elevated risk for developing diabetes to take immediate steps to prevent the disease, including adopting a healthier diet and increasing their daily activity. But what happens once type 2 diabetes is diagnosed? Is is possible to shift into reverse and travel back the way we came towards better health?
Until recently, the best evidence type 2 diabetes might be reversible has been seen in bariatric surgery patients who are both obese and diabetic. Gastric bypass and related procedures can rapidly and robustly normalize blood sugar levels. Ever since doctors made this striking finding, the goal has been to discover exactly how this works, and whether it can be reproduced without surgery.
Encouragingly, a few studies have since shown that it may be possible to reversed diabetes through lifestyle changes alone. Researchers in the United Kingdom discovered that deep reductions in calorie consumption, and subsequent weight loss, can reverse diabetes. They also found that these effects are quite durable, lasting for periods of up to six months.
However, the study does have a few caveats. For one, the study participants could only eat up to 700 calories per day. That goal was met by limiting their consumption to specifically designed shakes and vegetables. It might be difficult to get a large population of people to commit to such a strict diet for months at a time. The effects were also only seen in small groups of about a dozen people. To be reliable, many more people must be included in such a study, including both men and women from multiple ethnicities. Also, since the study only lasted for six months, many who had seen a reversal based on the strict diet saw the diabetes return after a year or more. This suggests such an extreme diet may not be a promising approach for long-term diabetes management.
As we continue to search for ways to reverse diabetes–for example, exploring the relationships between what bariatric surgery and profound calorie restriction do to glucose control—it’s likely we’ll start to see increasingly innovative and scalable strategies emerge to address the ongoing worldwide diabetes epidemic.