Can Your Lifestyle Reverse Type 2 Diabetes?
WORLDWIDE CRISIS: At least 136 million Americans have prediabetes or diabetes. By 2045, it is estimated that 700 million people worldwide will be affected by type 2 diabetes.
Exercise and diet can help you to manage type 2 diabetes-sometimes called non-insulin-dependent diabetes-but can these lifestyle factors help you reverse type 2 diabetes? For some people, lifestyle is enough to avoid medications but for others, medication is prescribed to keep blood sugar levels in check. When we talk about reversing type 2 diabetes, it usually means that you can keep your blood sugar levels below a certain level without the need for medications. Studies have suggested that it can be possible to do this through optimizing your lifestyle.
Blood sugar regulation involves several hormones: insulin, glucagon, and the pancreas. The goal is to keep your blood glucose levels within a narrow range to ensure that cells receive a steady and appropriate supply of energy each and every day. Here is how blood glucose gets elevated:
- The pancreas can’t produce enough insulin to help take glucose into cells (pancreatic beta cell dysfunction)
- Glucose isn’t carried into the cells because the cells stop listening to the insulin (insulin resistance)
- The liver produces more glucose because of high levels of a hormone called glucagon (this is also due to insulin resistance)
Type 2 diabetes is a chronic disease that affects the way the body metabolizes sugar. There is a progressive loss of sensitivity to insulin (pancreatic hormone that regulates blood sugar levels), and in the early stages the body produces more insulin to try to overcome reduced insulin sensitivity; however, the pancreas will not be able to produce enough insulin to maintain functional blood sugar levels-resulting in hyperglycemia (high blood sugar). Once hyperglycemia set in, the body begins to experience oxidative stress; oxidative stress contributes to many of the complications associated with type 2 diabetes: vascular, kidney, retinal, and nerve damage.
These levels may indicate a diagnosis of diabetes:
- Hemoglobin A1c > than 6.5%
- Fasting blood sugar > 126 mg/dL
The criteria for prediabetes if your blood tests show:
- Hemoglobin A1c is 5.7 – 6.4%
- Fasting blood sugar 100 – 126 mg/dL
Type 2 diabetes is a preventable, reversible chronic disease that, while genetics can play a role, is caused by nutrition and lifestyle factors. Let’s dig in a bit.
Symptoms of Type 2 Diabetes:
- Obesity-but cases are rising in non-obese people
- Tingling or numbness in hands + feet
- Fatigue
- Impaired vision
- Significant hunger or thirst
- Acanthosis nigricans-dry, dark patches of skin in body folds creases (armpits or neck area)
- Wounds take longer to heal
- Frequent urination (especially at night)
- Frequent infections
Complications of Type 2 Diabetes:
- Heart Disease
- Alzheimer’s
- Complications with hearing, vision, oral health + mental health
- Chronic kidney disease
- Nerve damage
- Foot problems
- Osteoporosis + fractures
Type 2 diabetes + weight loss
If you’re currently overweight (even by just a little bit), losing weight can help to stop type 2 diabetes from progressing further and becoming more severe. It’s also a key factor in reversing the condition.
Some people who are overweight have been able to bring their blood sugar levels down into a healthy range by losing weight and have continued to maintain healthy blood sugar levels without medications. This is generally considered to be a “remission” rather than a reversal as blood sugar can shoot up again if the weight is put back on.
Type 2 diabetes + diet
For a diet that helps to reverse type 2 diabetes, make sure you’re eating plenty of fruits and vegetables, good fats (nuts, seeds, avocados, olives), grass-fed protein (poultry, beef, fish) and beans are all great choices.
Keep processed, fatty and sugary foods and alcohol to a minimum or better yet-eliminate. Refined carbs, fructose and industrial seed oils are a big no-no, including white breads and pasta. Some fruits are also carb heavy, which can raise insulin levels. Some good low carb options are berries and watermelon.
Your gut health is often overlooked as a way to treat type 2 diabetes but there’s a strong link. Improving your gut health can help alongside other steps. Certain bacteria in your gut will aid in supporting optimal blood sugar levels. This study states that our intestinal microbiota has influence on on our weight, bile acid metabolism, inflammation, insulin resistance, and modulation of our gut hormones.
Not only is diet a factor but a sedentary lifestyle, inadequate sleep, chronic stress, and environmental toxins also play significant roles. All these factors affect our metabolic health and our overall wellbeing.
Type 2 diabetes + Exercise
Alongside diet, regular exercise can help to lower insulin resistance and keep blood sugar levels more stable. It’s also great for losing weight, which as we’ve discussed, is a big factor in reversing type 2 diabetes.
Any exercise is great but some can work better than others. Studies have shown that combining aerobic and resistance training can have a positive effect as far as insulin is concerned.
Whatever type of exercise you choose, aim for at least 150 minutes of moderate intensity activity each week.
If you’re overweight right now, you’ll probably want to speak with your functional medicine practitioner before getting started on a new fitness plan.
Type 2 Diabetes + Conventional Medicine
Bariatric Surgery is one of the more drastic ways to reverse type 2 diabetes.
A lot of people who have the surgery find that their blood sugar levels return to a normal range afterwards and they either need less medication or none at all. It’s usually only recommended if your BMI is high (35 or above) and you’ve already been unsuccessful in trying to lose weight and/or not been able to keep weight off for very long.
There are a many downsides to weight loss surgery though. Some people find that they don’t absorb nutrients as well afterwards, for example, and this can cause malnutrition and the down-stream effects that happen as a result.
Medications including metformin, sulfonylureas, meglitinides, DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT2 inhibitors that treat type 2 diabetes will always come with side effects. They are associated with liver and kidney dysfunction, nausea, fatigue, dizziness, rashes, weight gain, and hypoglycemia (low blood sugar).
Conventional Diet Guidelines-the American Diabetes Association’s dietary guidelines for type 2 diabetes are very outdated and promote a high intake of carbohydrates while demonizing healthy fats. This dietary approach not only doesn’t work for type 2 diabetes but actually worsens the symptoms. A study outlines how a low carb diet is used as a “first approach” method in diabetes management.
What do studies say?
In one study, people with type 2 diabetes were asked to do 175 minutes of exercise per day and eat 1,200 to 1,800 calories per day. Alongside this, they also received counseling and education.
A year later, roughly 10% of them were no longer taking medications to manage their diabetes or had become prediabetic (with their blood sugar levels no longer being high enough to class as diabetic). Those who had lost more weight tended to achieve the best results, as did people whose diabetes was more mild. Up to 20% of people from these categories came off their medications.
Low carb diets can reduce insulin production, which in turn lowers insulin resistance. In a 2014 study from the Second University of Naples, a low carb Mediterranean diet helped to reverse type 2 diabetes, with 15% of people achieving this after a year.
Here is another study of 30 patients who had been type 2 diabetics for 6 years or less and whose BMI classed them as as very overweight and obese. Half of them were put on a weight loss/management program program and swapped their normal diet for soups and shakes. After 3-5 months of this, they gradually returned to a solid diet. The other half continued with their medications and followed a more traditional diabetes care plan.
One year on, almost half of the first group went into remission compared to 4% of the second group. A big majority of those who lost 33lbs. went into remission. One major thing to take away from this study? There was no return to normal blood sugar levels for people who didn’t lose any weight.
Researchers put forward the idea that losing weight also reduces fat in the liver and pancreas and helps these organs to function better.
Will it work for you?
Changes are more likely to support if they happen fairly soon after you’re first diagnosed with diabetes. It’s more likely that lifestyle changes can stop the condition progressing if you’ve not had type 2 diabetes for a long time.
How to maintain healthy blood sugar levels:
- Get Functional Lab Testing done to know your risks: Glucose, Insulin, C-Peptide, Hemoglobin A1c, Lipid Panel, Complete Metabolic Panel, CBC, Thyroid Panel and various other markers specific to you; a functional medicine practitioner can support you with this
- Eat balanced meals of proteins, fats and complex carbohydrates; get rid of gluten and highly-processed foods
- Consider a Ketogenic diet for a short time to establish healthy blood sugar + a Mediterranean diet for long term
- If you need to lose weight; begin with the support of a functional medicine practitioner
- Get daily exercise + movement
- Make sure you are getting optimal sleep and normalize your circadian rhythm
- Work on reducing your stressors-stress affects our cortisol levels-work to maintain healthy levels
- Reduce environmental toxins
- Eat foods that support healthy blood sugar: blueberries, dark chocolate-yes!, organic coffee + tea (without the sugary creamers), fermented foods, soaked and sprouted nuts + seeds, extra-virgin olive oil, wild-caught seafood, grass-fed protein, pastured eggs, spices (garlic, curcumin + cinnamon)
- Consider supplemental nutrients: Vit D (get tested to check your level), Magnesium, B12 + Folate, Berberine, Alpha-Lipoic Acid, Chromium, Inositol, CoQ10 + Gymnema
Individualized Metabolic Wellness Plan
As you see there is so much you can do to reverse type 2 diabetes, and in turn, you improve your overall wellbeing. The main take-away is to maintain optimal weight, make healthy food choices, get appropriate exercise, and work on lifestyle factors. Work together with a licensed practitioner for professional recommendations regarding a weight-loss wellness plan, and once you begin to make small lifestyle changes the benefits will leave you feeling physically and mentally strong and healthy!