Can you reverse diabetes with diet? An expert dietitian explains

Key Points

• Type 2 diabetes is a complex chronic condition of insulin resistance.
• Many factors cause diabetes, including genetics and lifestyle.
• Like other chronic conditions, type 2 diabetes cannot be permanently reversed, but it can go into remission.
• Early diagnosis, a diabetes diet, key lifestyle changes, and, when necessary, diabetes medication can help prevent the health risks of diabetes.
• A personalized diabetes diet plan crafted by a Registered Dietitian can help you kickstart your journey toward better health.

Prediabetes and diabetes rates are on the rise in the United States. As millions battle these chronic conditions, many are intrigued by the possibility of using diet to reverse diabetes. 

But does this really work?

The not-so-good news is that, like other chronic conditions, it is impossible to reverse them permanently. On the other hand, your diet can make a massive difference in helping you keep diabetes or prediabetes at bay.

Let's explore.

What is diabetes?

At its core, type 2 diabetes is a disease of insulin resistance that happens when the body does not respond to insulin as it should.

Insulin is a hormone released by the pancreas in response to the food we eat and helps move blood glucose to various parts of the body for fuel. With insulin resistance, blood glucose tends to accumulate without being used for energy.

How to manage diabetes?

Managing diabetes is about maintaining a controlled A1C level. A1C, also known as hemoglobin A1C or just A1C, is a test that measures the average amount of sugar attached to hemoglobin over the past 2-3 months.

According to the American Diabetes Association (ADA), A1C levels over 6.5% are considered diabetes. Adults diagnosed with diabetes are advised to maintain a target A1C below 7%.

What is diabetes remission?

Diabetes remission or diabetes reversal is when blood glucose levels are maintained at a normal level (A1C less than or equal to 6.5%) for three months or more without diabetes medication.

Note: it is important to note that when people use the term ‘reversing diabetes,’ they are talking about remission, not a complete reversal.

What is prediabetes?

Prediabetes is when blood sugar levels are higher than normal but not high enough to be considered diabetes. 

According to the ADA, prediabetes A1C levels range from 5.7% to 6.4%.

Registered Dietitian, Rita Faycurry, RD explains, "If you have prediabetes, it is a sign that you may be at a higher risk of developing diabetes. Prediabetes is an indicator that some level of damage may have already begun to the heart, blood vessels, and other organs. I would treat prediabetes as an early wake-up call where lifestyle changes can help minimize the risk of diabetes."

How to reverse diabetes with diet?

Studies show that low-carbohydrate and low-calorie diets can help lower blood glucose levels to a normal range. A low-carbohydrate diet like the keto diet recommends that 20% of nutrients come from protein and the rest from fats and non-starchy vegetables.

Other nutritious diabetes diets include the Mediterranean diet, an eating plan centered around whole, natural foods, healthy fats like olive oil and nuts, legumes, and lean meats.

Registered Dietitian Faycurry, RD, says, “While low-carb and low-calorie diets work in the short-term, they may be challenging to maintain over the long haul. Remember that it's okay if a diet plan does not work for you. There are other diabetes diets you can try, and you do not have to figure it out alone. A Registered Dietitian can develop a personalized plan based on your preferences and needs.”

If you want to lose weight and lower your A1C, consider getting expert help from a Registered Dietitian. Fay can connect you to a Registered Dietitian Nutritionist near you, covered by your insurance.

Apart from food, how do you lower blood sugar levels?

Besides diet, other factors can help you manage your blood sugar. These include:

• Weight loss: Your weight is one of the biggest risk factors for diabetes. The good news is that if you have type 2 diabetes, losing even 5% of your body weight benefits your health.
• Getting regular exercise: Try to get 150 hours of moderate exercise a week (20-25 minutes a day); even a brisk walk will do.
• Walk after each meal: Even a 2-5-minute walk after meals can improve digestion and lower blood glucose levels.
• Move all day: Insulin takes glucose from the blood and directs it to parts of the body that need energy, with our muscles being a top priority. So, when we use our muscles more often during the day, they absorb glucose for fuel, which lowers sugar levels in the blood.

Why try to reverse diabetes?

Faycurry, RD, explains, "There are serious health consequences to diabetes. Even prediabetes, which people tend to ignore, is serious. It puts you at a higher risk for developing diabetes, heart disease, and stroke."

Controlling your A1C levels helps you manage your risk of diabetes complications like damage to the heart, blood vessels, kidneys, eyes, feet, the nervous system, gym disease, and systemic inflammation.

However, the ideal A1C target can vary based on your circumstances, so it's best to consult your healthcare provider or a Registered Dietitian Nutritionist for personalized guidance.

Managing diabetes takes more than A1C control

Having a controlled A1C does not necessarily mean that all aspects of your diabetes are fine.

A1C estimates average blood sugar levels over two to three months. However, it does not capture the day-to-day blood glucose spikes that can occur. These spikes, often triggered by meals, stress, or lack of exercise or sleep, can be harmful if they happen frequently, even if your A1C remains stable.

Eating a nutritious diet at regular intervals helps smooth out these spikes and maintain more consistent blood sugar levels. Common blood glucose meters are one way to track your daily blood glucose.

If your healthcare provider recommends it, you could use a continuous glucose monitoring (CGM) device to measure blood glucose at regular intervals during the day over a two-week period.

While a good A1C level is a positive sign, comprehensive diabetes care involves regular check-ups and monitoring of several health indicators to prevent complications.

What to eat when you're on diabetes weight loss medications?

According to Faycurry, RD, "Ozempic, Wegovy, Mounjaro, and Saxenda are weight-loss drugs that can help people manage diabetes. While these medications have many benefits, the best weight loss results also involve better nutrition and exercise."

Additionally, for some, the side effects of the drugs may be hard to manage. If they quit or lower their dose, they risk gaining weight. Research indicates that those who discontinue diabetes drugs could regain nearly two-thirds of their weight.

Eat foods that lower your blood sugar naturally. A diabetes-friendly nutrition plan and regular exercise can help prevent weight regain following medications such as Ozempic. 

Can a dietitian help you reverse diabetes?

Diabetes is a complex chronic condition that can lead to serious health consequences.

If you have prediabetes or diabetes, it can be hard to figure out what is the best diabetes diet for you.

A dietitian can help evaluate your nutritional needs, understand your food preferences and constraints, and develop a personalized nutrition plan just for you.

Fay can help you find a Registered Dietitian near you, covered by insurance.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.