You may have heard of type 2 diabetes remission, or perhaps you’ve even wondered, can type 2 diabetes be put in remission?
The answer is yes.
It was once thought that only bariatric surgery could put diabetes into remission. Research has now demonstrated that remission can be achieved through diet and lifestyle changes.
Before we talk about how to achieve diabetes remission, let’s define what remission means.
Diabetes Remission Definition
The first report on the concept of diabetes remission was published in Diabetes Care in 2009, where diabetes remission was defined as follows:
“Remission is defined as achieving glycemia below the diabetic range in the absence of active pharmacologic (anti-hyperglycemic medications, immunosuppressive medications) or surgical (ongoing procedures such as repeated replacements of endoluminal devices) therapy. A remission can be characterized as partial or complete.
Partial remission is sub-diabetic hyperglycemia (A1C not diagnostic of diabetes [<6.5%], fasting glucose 100–125 mg/dl [5.6–6.9 mmol/l]) of at least 1 year’s duration in the absence of active pharmacologic therapy or ongoing procedures.
Complete remission is a return to “normal” measures of glucose metabolism (A1C in the normal range, fasting glucose <100 mg/dl [5.6 mmol/l]) of at least 1 year’s duration in the absence of active pharmacologic therapy or ongoing procedures.”
“Prolonged remission is complete remission that lasts for more than 5 years (p. 2134).”
A position statement published in the British Journal of Diabetes in 2019, from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society, also provided a similar definition of diabetes remission:
“Remission can be achieved when a person with type 2 diabetes achieves:
1. Weight loss;
2. HbA1c <48mmol/mol (6.5%) or FPG <7.0mmol/l (126mg/dL) on two occasions separated by six months;
3. Following complete cessation of all GLT (p. 74).”
According to a more recent scoping review of studies, published in PlosOne Med in 2020, there were 96 different definitions of remission! The authors highlighted there is currently no international consensus about how diabetes remission is defined.
That said, many studies assessed in the review used the above definitions from 2009 as their guideline. So for our purposes here, let’s say these are the correct definitions for partial, complete and prolonged remission.
How to Achieve Diabetes Remission
There have been 3 methods shown to achieve diabetes remission.
Studies have shown that surgery can produce remission of diabetes.
However, weight loss surgery also comes with a whole new range of things to deal with:
- Possible complications
- Lifelong supplementation
- Long term nutritional deficiency
Really, surgery should be a last resort.
Interestingly, research experts reached the conclusion that it was the calorie restriction after surgery likely produced the remission, rather than the surgery itself.
Very Low Calorie Diets
There have been several studies showing very low calorie diets (600-800 calories per day) can put diabetes into remission.
These types of diets need to be conducted under strict medical supervision, as they are very low calorie. Obviously, these diets cannot be sustained long term, so afterwards, personalized dietary modification would need to be adhered to in order to sustain the results.
There has also been debate about the safety of these diets and their potential to cause harm to the body. By restricting calories the body needs for basal metabolic functions, there could be potential for negative effects on body composition and physiology.
Low Carbohydrate Diets
Many studies have shown that a low carb diet can put type 2 diabetes into remission. A most recent systematic review found that people with type 2 diabetes following a low carb diet had a 32% greater chance of achieving remission than following other diet plans.
Thankfully, a low carb eating plan does not require starvation or deprivation, nor surgical intervention!
In fact, a low carb diet is really a very flexible diet that is sustainable over the long term too.
Here at DMP we’ve been educating people about a lower carb way of eating since 2015. We’re proud to say our members and subscribers have achieved complete remission, a number of them have sustained their remission long term and are headed toward prolonged remission too.
To help you get started with a lower carb eating plan:
You can view our recommended food list here.
Learn where to get started with your low carb diet.
For more help and support, you might consider joining us as a member.
Carol Slater
I can wholeheartedly recommend the low carb diet for remission of diabetes. My partner has been following your advice since early in 2018 and is now 3 years in remission, has lost 65lbs and enjoys a wonderfully satisfying diet.
His Hba1c was 4.9 at his last blood work, his HDL,LDL, and triglycerides are all now within range, and total cholesterol figure almost in range. This way of eating is completely sustainable and we are so pleased we discovered very helpful your site, thank you. Carol
Jedha: Nutritionist (MNutr)
That’s fantastic Carol! Thanks for sharing 🙂