Reversing diabetes is a term that usually refers to a significant long-term improvement in insulin sensitivity in people with type 2 diabetes (T2D). People with T2D who are able to get their average blood glucose level to below 5.7 mmol/L or 102 mg/dl for over two or three months without taking diabetes medication are said to have put their diabetes into remission.
On finding out that I was diabetic, and experiencing a near collapse from a medicine prescribed to me, I began researching natural methods of lowering my blood sugar with a passion. I came across a method of reduced carbohydrate consumption that was guaranteed to lower my fasting blood sugar concentration to below 100mg/100ml in just three weeks.
It involved eating three meals a day, each meal comprising a cup of vegetables and any meat. The amount of food I ate was determined by a calculation of my basal metabolic rate. The carbohydrates were leafy or non-starchy vegetables. I ate about a cup full at each meal together with any type of meat so long as it wasn’t processed.
I was allowed to stave off any hunger with protein smoothies. The method was effective, and I saw my blood glucose levels melting each day. I intuitioned that exercise would help, so I would run on a treadmill and did weight training every day. After 21 days my fasting blood glucose level was under 100mg/100 ml. I also noticed that my midriff had shrunken.
However, I didn’t know about insulin resistance, and I naively thought that I was cured of diabetes. Indeed that notion was reinforced after a few weeks , when I had a blood test which showed my glucose levels were normal. That was in 2012.
Because at that time, I didn’t connect my weight gain with diabetes, I did not give weight control the importance that I would later realize it required. Seven years ago a blood test read 300mg/100ml. This time I tried a vegan approach.
The regimen was 30 to 60 days of raw vegetables, fruits and nuts. which for me basically meant salads. I drank an infusion of herbs before every meal to alkalinize my body fluids. I ran every day. I followed the diet for thirty days; and, indeed my blood sugar levels dropped to normal.
I went back to an omnivorous diet, but stopped eating bread and drinking milk. Since then I have lossed and gained weight several times, correlated with normal and elevated blood sugar levels. Today, a few months shy of my 70th birthday, I have resolved to permanently keep my T2D in remission.
Anybody reading this might rightly ask: “If he knows his condition and knows how to control it, then why does he relapse?” My honest answer is, it is because of an ignorance of the mechanisms involved in causing diabetes. Importantly, it is also because of my human condition: a lack of self-discipline brought on by times of inadequate mindsets, stress, worry about money, procrastination, family issues, and the list goes on.
Although I saw that my T2D could go into remission, I didn’t really know why until I saw the scientific proof that type 2 diabetes can be reversed. I would like to share this proof with you.
Probably one of the most important pieces of evidence of diabetes type 2 reversal comes from studies at Newcastle University in the northeast of England; the results of which are so convincing that treatments have been implemented for type 2 diabetics on a national level.
These groundbreaking studies were led by Professor Roy Taylor and his team. The team used magnetic resonance imaging (MRI). They scanned the muscles used for movement and posture – skeletal muscle, and noticed that five hours after a meal, non-diabetics stored 30% of the glucose in those muscles; but, type 2 diabetic individuals stored almost no glucose. Their skeletal muscle was insulin resistant.
Professor Taylor knew that the glucose which was normally stored in skeletal muscle had to be stored somewhere and the obvious place was in the liver because whenever there is more glucose in the body that can be immediately used for energy, or stored as glycogen, then that excess is very quickly converted to triglycerides in the liver.
Triglycerides are made of three fatty acid molecules. They are a type of fat called lipids and are used to provide energy in the body. So, as may have been expected, MR images of the livers of diabetics showed a much higher liver fat content than the livers of non-diabetic individuals. Their livers were malfunctioning in a certain sense because they developed insulin resistance. That is to say their livers did not respond to the hormone insulin in the normal way.
After a meal, instead of insulin causing the stoppage of glucose production, the storage of glucose as glycogen and the synthesis of lipids also to be stored , the insulin resistance results in glucose production and an increased synthesis of triglycerides. Cell Mol Gastroenterol Hepatol. 2019; 7(2): 447–456
As a result, the liver puts out more glucose and triglycerides into the blood. It is well known that T2 diabetic individuals have a 50% higher blood concentration of triglycerides than non-diabetic individuals.
Professor Taylor hypothesized a connection between the malfunction of the T2D liver and a malfunctioning pancreas, both organs important for maintaining constant blood glucose concentrations. He called the hypothesis, The Twin Cycle Hypothesis.
It states that a little too much food ingested over time, about ten years, causes fat to be built up in the liver. The liver then becomes gradually insulin resistant. Since insulin usually causes glucose to be converted to fat in the liver, but when the liver is insulin resistant, it puts out more glucose into the blood.
The pancreas reacts by putting out more insulin to try to drop the increased blood glucose levels. The higher insulin levels leads to more resistance which leads to more glucose put out by the liver as well as an increased conversion of glucose into fat within the liver.
One of the functions of the liver is to provide all the body with fat for energy, but as previously mentioned a malfunctioning liver will also leave too much fat in the blood. This fat then builds up in areas where it shouldn’t and one of those areas is the pancreas.
The fat stops the insulin producing cells (beta cells) from working properly and the glucose levels rise even more. So, two vicious cycles interact: on the one hand a malfunctioning liver, and on the other, a defective pancreas. Diabetologia 2008 51:1781 The takeway is that excessive fat causes T2D
If the Twin Cycle Hypothesis was correct, then it could be proved or disproved if weight loss would restore normal blood glucose levels, effectively putting the T2D into remission.
A study called Counterpoint proved Prof. Taylor’s hypothesis. Eleven people were put on a restricted diet for eight weeks and even after one week the amount of triglicerides in their pancreas and liver decreased. Their pancreas began to normally secrete insulin and their liver became insulin sensitive. After eight weeks, they lost an average of 15kg and were in T2D remission. Not only was the Twin Cycle Hypothesis proved, it also showed that the abnormalities of T2D are reversible by reducing dietary intake. Diabetologia 2011 Oct;54(10):2506-14.
The important question now was whether the remission was durable. Professor Taylor then made another study to address this. Subjects followed a very low carbohydrate diet for eight weeks. The study showed that their diabetes went into remission and that the remission was long lasting if there was no weight gain. The subjects were monitored for 6 months. Diabetes Care Vol. 39, Issue 5, May 2016
The findings that T2D remissions were long lasting prompted a national trial called the Direct Remission Clinical Trial where primary care nurses worked with patients to reduce their weight by an average of 14.5 kg.
Remission did occur: half of the group were still off their medication after one year with normal glucose levels, and 36% of the group achieved remission for two years. The study also found that they maintained a normal maximum insulin secretion rate if they maintained their weight loss. Diabetes Care 2020;43:813-20.
In 2024, the scheme is ongoing nationally in England and Wales, and remission figures of 30 to 40% are expected.
A common belief amongst the medical profession, including medical schools, is that T2D is related mainly to obesity, and that it is obesity and being overweight per se that is the most important risk factor for both children and adults. This view is held mainly because obesity, insulin resistance and metabolic syndrome – a group of conditions that raise the risk of heart disease,stroke, and diabetes – usually precede the development of T2D.
However this does not explain the fact that a lot of obese people never develop T2D, and that individuals with a normal body mass index (BMI) do contract diabetes.
Professor Taylor together with Prof. Rury R Holman of Oxford University hypothesized that it wasn’t weight gain per se that was causing the diabetes but rather a genetically determined weight gain threshold. That is to say that if a person has common T2D, then they have put on more weight than their particular body can handle. Clin Sci (Lond) 2015 Apr;128(7):405-10
This hypothesis would be proved if it could be shown that people with T2D of normal weight exhibited the same changes that occur with T2D of obese or overweight people. In other words, their blood glucose levels would return to non-diabetic glucose levels.
A clinical trial proved the hypothesis when a study of T2D individuals of normal weight showed that after losing weight, their blood glucose levels also became normal. Clin Sci (Lond). 2023 Aug; 137(16): 1333–1346
In summary, it has been proven that ordinary type two diabetes is caused by an untolerated excess of fat which is determined by the genetic make-up of each individual. It has also been proven that by reducing body fat to below an individual’s threshold, remission of their T2D is possible. T2D can therefore, be reversed, and the remission will remain as long as there is no regain of weight.