Regina Leader-Post

Is it possible to reverse diabetes?

Preventive lifestyle strategies can pay off, Dr. David A. Chokshi writes.

- For The Washington Post

Q Can I reverse my diabetes? Can I get off my medication­s, or will I have to stay on them for my whole life?

A There is no cure for diabetes, but it is reversible in some cases.

Diabetes mellitus is a condition in which blood sugar levels are too high. Its root cause is a problem with insulin, a hormone produced by the pancreas, which allows sugar to travel from blood vessels into our body's cells.

In Type 1 diabetes, the pancreas produces little to no insulin, while in Type 2 diabetes, the body stops responding to insulin properly. In both types, elevated blood sugar can damage our bodies, leading to heart disease, kidney problems, nerve issues and even blindness.

Weight loss — even five to 10 per cent — can improve blood sugar levels and lessen the need for medication­s for Type 2 diabetes. More radical lifestyle changes — overhaulin­g your diet and exercising more — and weight-loss ( bariatric) surgery can lower weight and lead to reversal of Type 2 diabetes for some people.

Type 1 diabetes, caused by an autoimmune response against part of the pancreas, cannot be reversed — though scientists are working on a cure.


Testing may show you have diabetes or prediabete­s. Prediabete­s means you have higher blood sugar than normal, but not yet high enough for a diabetes diagnosis. Think of it as the yellow in a traffic light: There's a significan­t risk of it progressin­g to diabetes without changes to your lifestyle.


Any time one of my patients is diagnosed with diabetes, I consider it an “all hands on deck” moment. Not just for our clinical team, but also for the patient and family. The first few weeks after a diagnosis are critical for establishi­ng new patterns, from dietary habits to keeping blood sugar logs to managing medication­s.

A number of new diabetes medicines have come on the market in recent years. Some such as glucagon-like peptide 1-based therapies (such as semaglutid­e, liraglutid­e and tirzepatid­e) lower blood sugar but also slow digestion and help with weight loss.


We know that Type 2 diabetes can be reversed. A study in the United Kingdom, known as the Diabetes Remission Clinical

Trial (DIRECT), showed that patients could reduce blood sugar below diabetic levels.

All diabetes drugs were stopped and meals were replaced with a strict 800-calories-a-day diet that was mostly healthy shakes. Then real food was gradually reintroduc­ed, and patients were supported by dietitians, nurses and tailored workbooks to maintain their weight loss.

If this sounds intense to you — it is. But so is injecting yourself with insulin every day!

Anyone who has tried to lose weight knows the toughest part is keeping it off. My advice is to think about what nutritiona­l changes you can sustain over years, not weeks.

A Mediterran­ean diet has perhaps the strongest long-term scientific evidence supporting its use in Type 2 diabetes. Plantbased and vegetarian diets have also been shown to be effective for the prevention and treatment of Type 2 diabetes.


My father has had Type 2 diabetes for over 30 years, but he has been able to control it and hasn't had to start insulin. There are immense benefits to managing the disease well.

We focus on the “ABCS of diabetes”: his A1c, or average blood sugar, which we keep below seven; his blood pressure; and his cholestero­l.

Keeping blood sugar at or near the goal level helps protect the eyes, kidneys and nerves. And keeping blood pressure and cholestero­l levels under control reduces the risk of heart attacks and strokes.

My father is on medicines for each of the ABCS, but we always look for opportunit­ies to pare back on his pills through better eating and more exercise.


We can take steps to reduce our risk of developing diabetes. Eating more fruits and vegetables and less meats, sweets and refined grains (such as white bread and pasta) is important.

It's a myth that people concerned about diabetes should avoid fruit; eating whole fruit is a good source of fibre, vitamins and minerals.

Sugary drinks such as soda and juice should be rare indulgence­s, as should ultra-processed foods such as starchy snacks, chips and crackers, and packaged food such as energy bars.

Shifting to whole grains, like switching from white rice to brown rice, also helps.

I'm vegetarian and started a version of intermitte­nt fasting a few years ago, whereby I eat only between the hours of noon and 9 p.m. each day.

Physical activity also matters. Hitting the gym is great, but walking, gardening and dancing all count. If you have fun while you're exercising, it feels like less of a chore, and you're more likely to keep doing it. Some studies show combining strength training with aerobic exercise lowers diabetes risk more than either alone. Depending on your age, weight and test results, your doctor may also consider some medication­s — such as metformin or semaglutid­e — to help stave off diabetes.

The benefits of preventing diabetes are remarkable. Studies estimate that a diagnosis of diabetes at age 40 reduces life expectancy by six years. An ounce of prevention is worth a pound of cure — and a few birthdays, too.

 ?? GETTY IMAGES/ISTOCKPHOT­O ?? In some cases it is possible to reverse a diagnosis of Type 2 diabetes, but it demands a multi-pronged approach involving weight control, exercise and a discipline­d form of eating.
GETTY IMAGES/ISTOCKPHOT­O In some cases it is possible to reverse a diagnosis of Type 2 diabetes, but it demands a multi-pronged approach involving weight control, exercise and a discipline­d form of eating.

Newspapers in English

Newspapers from Canada