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  • Q&A with Australian Health Practitioners

    Can you reverse Type 2 Diabetes by exercise and diet?

    What can I do to with my diet and exercise to reverse my type 2 diabetes?
  • Find a professional to answer your question

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    Hi, I’m an Inner-West Sydney based Nutritionist and Accredited Practicing Dietitian. I’m committed to helping people finding a way of eating that allows them to ... View Profile

    While Type 2 Diabetes can't be reversed, it can be controlled with a good diet and exercise, and you may not need to take any medications. 

    The Diabetes Council has a really great example of a good diet here. 
    Aiming for 30 minutes of exercise each can help too. Here's a good information sheet. 

    If you want more individualised advice, I'd recommend making an appointment to see a dietitian. Your doctor may be able to give you a referral so you get a medicare rebate. 
     
    Please feel free to get in contact with me if you have any questions. 
    Sincerely, 
    Jessica

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  • Stuart Donaldson

    Exercise Physiologist

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    Accredited Exercise Physiologist with ESSA providing services to clients in the Hervey Bay region, including entitled DVA clients (Entitled Department of Veterans' Affairs clients may ... View Profile

    Unfortunately, at present, Type 2 diabetes is a disease for life. However, many people are able to successfully control the condition and not develop any other complications, such as diabetic retinopathy or peripheral neuropathy.

    This is best managed by a combination of diet, exercise and medication.

    Exercise guidelines recommend a minimum of 30 minutes every day to be considered ‘sufficiently active’ for health benefits. However, the more the better. Exercise increase the amount of blood glucose/sugar that can enter the muscle cells in the body, thus lowering the blood glucose/sugar levels (which are elevated in diabetics).

    This is why frequent, regular exercise is recommended. Every day would be ideal, as the effect of exercise improving blood glucose control is only a short term (up to 48 hours or so), so you will need another bout of exercise to restart the process.

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    Accredited Dietitian and Nutritionist specialising in food allergies, food intolerance and strategies for weight loss. I'm passionate about good nutrition and love working with clients ... View Profile

    Once someone is diagnosed with type 2 diabetes then that person is generally considered a dibetic for life, however…. there are PLENTY of cases where individuals, through dietary modification and exercise, have succesfully managed their blood sugar levels to “non diabetic levels”. There isn't a point of no return that you cross with blood sugar levels, and your body can change and adapt. The key to improvement is a term called “insulin sensitivity” which is the opposite to “insulin resistance”. Your body can increase its insulin sensitivity so that your blood sugar levels are better controlled. Excercise and diet modification can both help with this.

    Hope that helps!

  • Eric Rosario

    Exercise Physiologist

    Master of Applied Science by Research into the Effects of Strength Training on Postmenopausal women. I have been involved in strength training for 67 years ... View Profile

    It is generally believed that Type11 diabetes cannot be reversed but I have  known several cases where the client has been able to do so. Let me clarify my answer, several of my clients who have been confirmed as having Type 11 diabetes are now living free of any medication but they are still training hard and are reasonably careful of their diet.
    It is a known fact that increased muscle mass increased insulin sensitivity therefore the focus is on increasing muscle mass of the large muscles of the body, the quads, hamstrings buttocks and back.
    Increased muscle mass also increases the Basal Metabolic Rate which in turn reduces the fat mass. Added to this relaxation practices also tends to reduce Omental fat a major factor in TD2M. Reducing stress by Meditation is useful but I would also suggest reducing stress in daily life by not trying to accumulate your third million– or is it the 10th-  at the cost of your health. Aim at sufficiency in life's needs. Eric Rosario pericros@alphalink.com.au

  • Kirsty Woods

    Exercise Physiologist

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    Hi I’m Kirsty Woods,I would like to use my experience, expertise and passion to help you reach your weight, energy and health goalsI have been ... View Profile

    Although it is debatable as to whether type 2 diabetes can be completely reversed, evidence (and many of my clients) has demonstrated that lifestyle modifications including activity and diet can reduce diabetic symptoms, health outcomes and medication usage, even without weight loss.

    The main mechanism by which these changes occur is through the improvement of insulin sensitivity. If you are not already doing so, I recommend that you participate in regular resistance based exercise (such as theraband exercises, swimming, weights) to preserve/build muscle mass and improve management.

    You may also wish to take a look at this recent article looking at carbohydrate reduction as the first approach in diabetes management:

    http://www.sciencedirect.com/science/article/pii/S0899900714003323

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    Elizabeth Newsham-West is committed to optimising the health and well-being of people across all ages within the Mount Tamborine community.  She works as a domicillary ... View Profile

    The low carbohydrate has become a popular diet today however I will draw your attention to some “Thinking points” you should consider when reading this article that is posted above.
    Firstly the attached article has an author who has a personal and financial interest in the promotion of a low carbohydrate diet. She is already selling books and diet plans she has authored on this topic which suggests bias cannot be ruled out. Secondly the studies used to support this diet are short term with low number of participants which we term “ Proof of Concept Studies”.  Even the study attached highlights that there is no long-term randomised controlled trials (RCT) being the gold standard  done in this area to prove this “proof of concept” yet. Healthcare professionals who treat are not interested in 6 month interventions but what can improve health long term.

    A: There is no consensus on what a low carbohydrate diet is yet everyone talks about them as if they are all the same. There are enormous nutritional differences.
    So what is a low carbohydrate diet?  It can be as low as 20gm/carbs a day which means you cannot eat any fruit and vegetables let alone dairy products, beans or legumes in a day. Or a low carb diet can just mean no bread, sugar, potatoes or starch vegetables, rice or pasta .Or it can mean less than  40%Energy from carbs which is about 200gm carbs  on a 2000Kcal/day diet which has a greater scope to include more foods that contain carbohydrate. Remember carbohydrate is also found  in  fruit, vegetables, dairy products, beans and legumes and most well known cereal grains. Dietary recommendations for peoples with T2 diabetes is around 45-60% of energy from carbohydrate choosing good  quality carbohydrate to meet many different lifestyle and nutritional needs.
     Each of these diets described above are quite different nutritionally from each other, so we cannot assume they are the same when it comes to health benefits.  The article attached in the post above stated that before the obesity crisis most Americans were eating around 43% of their energy as carbohydrates. Interestingly they also say the average carbohydrate intake in Americans today with the obesity crisis is around 49% of energy. As we can see there is very little difference. So this tells us there is something more about this story not to mention lifestyle.

    B: Most studies on high carbohydrate diets do not determine the quality of carbohydrate. So we cannot rule out that the majority of carbohydrate may have been coming from processed carbohydrate foods like pasta, rice, breakfast cereals breads, muffins, muesli bars and  sugar sweetened beverages (SSB) etc. If the high carbohydrate diet came from foods like fresh whole fruit and vegetables, dairy products and dried beans, legumes and lentils is it better? We do not know as we do not have this research though it is partly addressed by the Mediterranean Diet and the glycaemic index. So we cannot talk about carbohydrate without talking about the food and the form in which the carbohydrate is being eaten.

    C: If a diet is low in carbohydrate then it is high in something else. This is usually FAT. We know that a diet high in processed carbohydrate eg SSB is as bad as a diet high in fat. What we don't have is RCT showing differences in a diet high in more intact carbohydrate like whole fresh fruit, vegetables, dried beans , legumes, lentils, different cereal grains ( quinoa, oats etc) dairy products compared to proceesed carbohydrates and high fat diets. However the Mediterranean diet suggests to us quality carbohydrate, high fruit and vegetables, dairy products might be just the way to go.

    D: Already mentioned the diet plan that consistently comes up trumps is the Mediterranean diet which is neither low carbohydrate or high fat. This diet addresses quality by talking food not nutrients and has been around for a very long time with some great health outcomes.

    E: Those advocating less than 100- 120g/day of carbohydrate  will be at of risk of having  inadequate fresh fruit and vegetables, insufficient fibre especially soluble fibre required for a healthy gut and  insufficient dietary calcium.
     
    Maybe consider a much longer term study than that used in the article attached- a prospective cohort study ( not a RCT) of 82,802 US nurses over 19 years, reported that a low-carbohydrate dietary pattern that  emphasizing animal sources of fat and protein was associated with a higher risk of type 2 diabetes mellitus and all-cause mortality. In contrast a low-carbohydrate diet that emphasizing high intakes of vegetable protein and unsaturated fat was associated with a lower risk of coronary heart disease over 19 years of follow-up.  The investigators also found this pattern was associated with a lower risk of cardiovascular and all-cause mortality among both men and women.

    We need to stop talking nutrients and start talking FOOD.

  • Anonymous

    I have been reading about low carb diets high protein high fat diet such as paelo and there reports are finding more people are getting healthy are going into remission not only for diabetes but for other chronic diseases.  It makes me wonder when the low fat high carb diet came around about 30 years ago the epidemic of people with chronic diseases has increased.  More people are overweight diabetic suffering from sever chronic diseases Can someone explain this why are we still promoting this diet when there are doctors now telling us they think they got it wrong I see this on a TV show Catalyst.  there are scientific prove that we should be on a high fat protein diet with health vegetables and salad, remove carbs like bread, pasta etc., from our diet and people are becoming healthy loosing weight and controlling their health.

  • Emma Boucher

    Psychologist

    Emma Boucher is a Registered Psychologist, Nutritionist and Naturopath. With 19 years experience, Emma is specialized in treatment for anxiety, stress, weight managment and depression ... View Profile

    Some great suggestions have been posted =) Managing the impact of diabetes can be very stressful at times. Making changes to your diet as well as increasing you activity level can improve both your physical and mental health
    Best of luck

  • Eric Rosario

    Exercise Physiologist

    1

    Agree

    1

    Thanks

    Master of Applied Science by Research into the Effects of Strength Training on Postmenopausal women. I have been involved in strength training for 67 years ... View Profile

    I would equate Type 11 diabetes to being an alcoholic, you are never totally cured the propensity to a relapse is always there. On the other hand it is possible to live a life time if you change your life style. I would also like to point out that it is not weight loss but fat loss that is important. A gain in muscle mass may result in a gain of weight while there is a loss of fat. Eric

  • Dr Kevin Lee

    Endocrinologist, Nuclear Medicine Physician

    4

    Thanks

    Consultant Physician in Endocrinology, Diabetes & Nuclear Medicine. I help patients with diabetes, thyroid, osteoporosis and hormone disorders. I am also an imaging specialist in ... View Profile

    Yes,  sort of can*. 

    *. 
    Depends on if you believe in the operational definition of “cure” in T2D to mean “prolonged complete remission”

    I congratulate on all the contributors so far, they are all correct in saying that strict definition of “cure” is not possible for T2D.

    It turns out it is quite a controversial topic “cure”. ADA in 2009 tried to define “cure” as “prolonged complete remission”(1).

    If we use this ADA operational definition, then yes, many of us have seen “prolonged complete remission” of T2D by diet/exercise.

    1. Buse JB, Caprio S, Cefalu WT, et al. How do we define cure of diabetes? Diabetes Care. 2009; 32:2133–2135.  

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