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Have you ever read claims that type 2 diabetes can be “cured” and wondered if it’s true?
According to Diabetes UK, more than five million people are thought to have diabetes, of which 90% have type 2 diabetes.
Type 1 diabetes is thought to be an autoimmune disease (which develops when the body’s immune system destroys the pancreatic cells that produce insulin – a hormone that keeps blood sugar levels in the normal range), while type 2 diabetes develops when the body no longer produces enough insulin or the insulin no longer works properly (insulin resistance), causing blood sugar levels to become too high.
Over time, it can lead to a variety of complications, including nerve and blood vessel damage affecting the eyes, kidneys and legs, and an increased risk of heart attack and stroke.
But can type 2 diabetes really be cured?
Diabetic remission
Natasha Marsland, senior clinical adviser at Diabetes UK, said ‘remission’ was a more accurate word to describe it.
“Remission of type 2 diabetes is when blood glucose levels drop below diabetic levels for a period of at least three months without the need for antihyperglycemic medication. By keeping blood glucose levels in the non-diabetic range for a long period of time, the symptoms of diabetes and the new damage that diabetes can cause to the body are halted.”
“Remission does not mean that your diabetes is permanently cured – your blood sugar levels may rise again. Also, remission is not a cure for type 2 diabetes, so we don’t call it ‘reversible type 2 diabetes’. You should continue to have regular checkups and get the support you need to treat or manage any existing complications.”
How does diabetes remission work?
“The evidence shows that the key to remission is weight loss – the sooner you try to lose weight after diagnosis, the better your chances of remission,” says Marsland. “If you’re living with obesity, losing around 15kg (2 stone 5 pounds) as safely as possible will increase your chances of going into remission of type 2 diabetes.”
Weight is one of many risk factors associated with type 2 diabetes, along with genetics, family history, age and ethnicity (South Asian, Chinese, African-Caribbean and black African people are generally at higher risk). But while weight is an important factor in remission, Marsland also points out: “Weight loss does not guarantee remission of type 2 diabetes. However, losing weight when necessary can have a positive impact on your everyday health and wellbeing, and your long-term health.”
“The causes of type 2 diabetes are varied and complex, but we know that in many cases it is caused by the accumulation of fat in the liver and pancreas, disrupting their normal function.”
For some people, weight loss surgery and medications (such as Ozempic or Wegoby) may be effective. Nutrition and a healthy diet are also important.
Type 2 diabetes and nutrition
“The majority of research shows that losing weight reduces insulin resistance and blood sugar levels, but we also know that 10% of people diagnosed with type 2 diabetes are at a healthy weight,” says William Hadfield, specialist diabetes dietitian who has worked in the NHS for over 10 years and is co-founder of WE Nutrition (wenutrition.co.uk).
“People with type 2 diabetes who are unwilling or unable to lose weight may want to focus on reducing their overall carbohydrate intake (such as bread, rice, pasta, potatoes, and cereals) and increasing lean proteins (such as beans, lentils, eggs, white meats, and fish), vegetables, and healthy fats (such as nuts, seeds, olive, canola, and nut and seed oils and spreads).”
“Staying hydrated with unsweetened liquids (such as water, sugar-free squash, unsweetened tea or coffee) and only consuming alcohol within recommended amounts can help with overall health, hunger management and avoiding unnecessary calorie intake.”
“Avoiding added sugars is important for everyone, especially people with diabetes, as they are linked to obesity and tooth decay. For people with diabetes, added sugars can lead to increased blood sugar levels. These foods (such as sweets, chocolate and highly processed foods and drinks) have little to no nutritional value and therefore little health benefit,” he added.
Make the choice that’s right for you
Hadfield is keen to focus on sustainable change. “Choose an approach to eating that suits you and your life,” she says. “Consider all aspects of your life, think about how food, drink and lifestyle fit into it, and find ways to allow you to live the way you want to, while also supporting you to achieve your health goals.”
He suggests “avoiding overly restrictive or fad diets unless overseen by a trained and qualified medical professional,” adding: “In a fast-paced world where we expect instant results, we sometimes expect the same to apply to our health. It’s important to recognize that slow and steady change can sometimes win the race to your health and type 2 diabetes.”
What else do you need to know?
Marsland stresses the importance of staying in constant contact with your medical team.
“Whether you’re trying to achieve remission of your type 2 diabetes, are already trying or your type 2 diabetes is in remission, it’s really important to speak to your healthcare team – you need advice and guidance that’s right for you,” she says. “It’s also important to highlight that aiming for remission is not clinically appropriate for everyone. If you are trying to achieve remission, you may need to change the medications you’re taking, which your healthcare team can advise you about. Increased monitoring may also be recommended.”
“We know that getting into remission can be hard and staying in remission at a healthy weight can be even harder, which is why we’ve launched new remission information and support resources. [available on the charity’s website] And we continue to fund research to find ways to help people with type 2 diabetes get and stay in remission longer.”
Hadfield also believes that because diabetes affects so many areas of your life, a holistic approach is key: “Consider not just what you eat and drink, but also your mental health, exercise, sleep, support networks and relaxation. All these parts of the jigsaw come together to make the person you are, so it’s important to look at the whole puzzle to get the best results.”
