Can Type 2 Diabetes Be Reversed or Put Into Remission?
Type 2 diabetes affects more than 35 million Americans and has long been considered irreversible. New research and medical perspectives suggest that while the disease may not be permanently cured, many individuals can achieve remission through weight loss, lifestyle changes, and medical support, though relapse remains common without sustained intervention.
Type 2 diabetes mellitus (T2DM) is a chronic, life-altering condition affecting more than 35 million Americans. The disease occurs when a person’s cells do not respond to insulin properly, causing high blood sugar levels. Excess glucose in the blood can harm the body, potentially damaging the kidneys, heart and eyes.
Around one in 10 Americans has diabetes, and 90 to 95% of them have Type 2, according to the Centers for Disease Control and Prevention.
The disease has long been considered irreversible, but recent research suggests that it may be possible to reverse T2DM or, at the very least, put it into a state of remission. Some medical experts are now comfortable discussing T2DM reversal, noting studies show significant weight loss can restore normal metabolic function, the process by which the body turns food into energy.
A report from Yale School of Medicine (YSM) notes that Type 2 diabetes can be reversed by reducing insulin resistance. Defining research by Gerald I. Shulman, George R. Cowgill Professor of Medicine (endocrinology) and Cellular and Molecular Physiology at YSM, and Kitt Petersen, professor of medicine (endocrinology) at YSM, found that modest weight loss — even as little as 10%— can reduce insulin resistance and reverse T2DM. However, the study also found that most people who lost weight later regained it.
The report adds that anti-obesity GLP-1 medications, such as Trulicity and Ozempic, can help individuals with diabetes maintain long-term weight loss as a treatment for the disease. “Loss of fat around the liver and pancreas can allow the body’s insulin producing cells to regain function,” said Dr. Olalekan Otulana, a general practitioner and physician.
“People who achieve this tend to have been diagnosed relatively recently and may also have excess body weight to lose. It is important to emphasize that this requires a structured and supported approach, often involving a planned dietary program, increased activity, and medical monitoring.”
Austin Shuxiao, a board-certified internal medicine physician, is among medical experts who argue that diabetes cannot be truly reversed, though remission can be achieved. Remission occurs when an individual with T2DM maintains normal blood sugar levels for three months or more without taking diabetes medication.
“Typical maintenance of T2DM involves keeping blood sugar within a target range and subsequently keeping HbA1c (Hemoglobin A1c) at a manageable level, typically between 6–7%,” said Shuxiao. “When HbA1c reaches a non-diabetic or prediabetic range, less than 5.7%, then we can say the diabetes is in remission.
The key determinants of whether this is achievable is the duration of diabetes and the degree of insulin resistance.” Shuxiao said the longer a person has diabetes, the less likely they are to achieve remission due to insulin resistance accumulating in the body over time. Experts caution that the term “reversal” can be misleading because, without sustained lifestyle changes, the disease can return.
In a large study led by Barune Thapa, a medical student at the Kaiser Permanente Bernard J. Tyson School of Medicine, and colleagues, 556,758 adults with T2DM were analyzed. About 2.9% achieved remission over three years, though 36.9% of them later relapsed.
Shuxiao believes dietary education is crucial for people with diabetes to achieve normal blood sugar levels without dependence on medications. But Shuxiao emphasized that even if individuals lower their A1c to a non-diabetic range, they will always carry a formal diagnosis of diabetes.
“Lifestyle changes are foundational, and medications are there to assist,” he said. “I can understand that people don’t want to change the way they eat to accommodate diabetes, but they cannot truly manage their diabetes if they don’t manage their diet.”
Medical experts note that once someone develops significant insulin resistance, their body remains at higher risk of regaining it, even if blood sugar is controlled and they are off diabetes medications entirely.
Though debate continues over whether T2DM can truly be cured or reversed, medical experts agree that individuals with the disease can and should learn to regulate their blood sugar and insulin levels.
Tashi McQueen writes for The Afro.