When you’re newly diagnosed with type 2 diabetes, chances are that one of two things happens. Either you’re given a prescription, a crash course on using a blood glucose meter, and very little else; or you’re bombarded with more advice and information than you can take in.
Most people will experience the second scenario. Those who don’t will probably spend a considerable amount of time scouring the internet for information about diabetes. In both cases the days, weeks, and even months following the diagnosis can leave you feeling more than a little shell-shocked. So what is the most important advice for a newly-diagnosed type 2 diabetic?
Stop. Take a deep breath. And don’t panic. Because there’s more to the type 2 diabetes story than you may have been told.
Is type 2 diabetes really incurable? It depends on how we define “cure”
The one consistent piece of information most people receive from their doctors is the statement that type 2 diabetes is a chronic, progressive, and incurable disease. Even physicians who are open to managing diabetes through lifestyle changes assume that their patients will inevitably need medication. They also assume that the number of prescriptions and the dosage will expand as the years go on. Based on this assumption, the trend is increasingly to skip lifestyle management altogether and go straight to medication, and to treat more aggressively from the outset.
However, a growing body of research shows that type 2 diabetes isn’t necessarily a chronic, progressive, and incurable disease. Multiple studies show that many people with type 2 diabetes can actually reverse the disease and bring their blood glucose, insulin levels, and other biological markers back down to pre-diabetes levels. The most well-known of these are the Newcastle studies, in which people reversed their type 2 diabetes using an 8-week very-low-calorie diet.
It’s also well-known in medical circles that weight-loss surgery often leads to reversal of type 2 diabetes, and there have been calls to push this option more aggressively in extremely overweight diabetes patients. Ongoing studies into low-carbohydrate diets suggest that they too can lead to diabetes reversal if followed consistently, although the results aren’t as rapid as the 8-week Newcastle diet or bariatric surgery.
In study after study, people have successfully brought their glucose and insulin levels back down to the non-diabetic range. Doctors are reluctant to call these people “cured” because they could, at some point, become diabetic again. Nevertheless, the end result was the same: people were able to stop taking their medications (even insulin) and their test results were indistinguishable from those of people who had never had type 2 diabetes.
Less really is more, where your weight is concerned
The studies showing that type 2 diabetes is reversible all have two common threads. The first is that people lose a significant amount of weight (30 pounds on average for the Newcastle studies and low-carb diets, more with bariatric surgery).
The Newcastle studies showed, through MRI imaging, that diabetes reversal happens when people lose enough fat from their liver and pancreas (the organ that makes insulin). Too much fat in these organs can “clog up” the system and keep your body from producing and using insulin correctly —and a single gram of fat can be enough to tip the scales into type 2 diabetes. 30-33 pounds seems to be the “magic number” leading to weight loss in these vital organs.
The studies also show that those who regain the weight will probably also regain their diabetes along with the pounds. Which brings us to the other, equally important common thread all the studies have: people also change the way they eat.
You are what you eat: your diet is key to your health
Those who have successfully reversed their diabetes and maintained that reversal long-term have also made changes to the quality, quantity, and/or composition of what they eat. As we explain in the DWD Lifestyle Blueprint, 21st century life makes it virtually impossible not to overeat—even those of us who think we’re eating an entirely appropriate amount. With oversized plates the norm, snacking encouraged at every turn, and nutritional guidelines advising us to base our diets on whole grains, it’s all too easy to take in more calories than we can burn on a daily basis.
It’s also too easy, thanks to our overreliance on processed foods and hidden sugar in virtually every product on the market, to take in far, far more carbohydrates than our bodies can possibly handle. (For a crash course on just what carbohydrates are and how they affect our bodies, see What are carbohydrates and how do they impact your health?) Long-term, this leads to insulin resistance, fat storage and weight gain, overeating and, eventually, type 2 diabetes.
And if you’re already diabetic, eating a high-carb diet is a sure-fire way to keep your blood sugar elevated. Carbohydrates are the one macronutrient guaranteed to cause blood sugar spikes, and the one macronutrient we can completely do without. Without carbs, our bodies turn to fat to meet our energy needs. And yet standard advice for newly-diagnosed type 2 diabetics isn’t to cut back on the amount of carbs they eat but instead to eat 45-60 grams of carbohydrate at each meal—a high-carb diet.
As obesity doctor Sarah Hallberg tells us, “We are essentially recommending that they eat exactly what’s causing their problem.”
While your diabetes team undoubtedly has the best of intentions, there’s a major disconnect between standard treatment and what’s actually working in practice. While conventional wisdom still says that type 2 diabetes is inevitably chronic, progressive, and incurable, the scientific literature shows that this is not necessarily so. However, there’s no “quick fix”. There’s no magic pill, or “one simple trick to beat diabetes.” Instead, what’s required is serious commitment and a willingness to make real and lasting changes in some fundamental parts of your life, particularly diet.
The most important advice every newly-diagnosed type 2 diabetic should hear is simple:
- Don’t give in to despair—the progression from one med to another and eventually to insulin is not guaranteed. Many, many people have successfully reversed their diabetes long-term.
- Weight loss is essential.
- Carbohydrates are not your friend, no matter what you may have been told. A steady diet of excess carbs means chronically high blood sugar and all the physiological damage that comes with it.
- Although type 2 diabetes isn’t a life sentence, there isn’t a quick fix. It means changing your diet and lifestyle in fundamental ways.
- The likelihood of reversal is tied to how long you have had the disease. The earlier you begin making the necessary changes, the more likely you are to succeed.