What is type 2 diabetes?
Up to 90 percent of all people with diabetes have type 2 diabetes, a chronic condition that leads to rising blood sugar levels. Many people suffering from type 2 diabetes are wondering whether it is possible to “reverse” the condition and become healthy. Reversing a disease condition means normalizing all factors that contribute to an increased risk of complications; in diabetes, it means normalizing blood sugar levels and, in the majority of cases, returning to normal blood pressure and body mass index.
There have been discussions, particularly in the news media, about the possibilities of reversing one’s diabetes by applying different diets, but before we go into whether this is possible or not, it is important to understand exactly what diabetes is.
There are two main types of diabetes
Type 1 diabetes: type 1 diabetes (also called insulin-dependent diabetes) usually affects children and adolescents. Type 2 diabetes: type 2 diabetes (non-insulin-dependent diabetes) tends to affect adults over 40 years of age and overweight people. Other types of diabetes include gestational diabetes associated with pregnancy, and secondary diabetes where diabetes is caused by other conditions (e.g. inflammation of the pancreas) or of certain medications such as steroids.
Insulin is a hormone produced by the pancreas, an organ located near your intestines and stomach. The hormone controls the absorption and consumption of glucose (sugar) in the body. Sugar levels in the blood will rise if the pancreas produces insufficient insulin (type 1 diabetes), or if the pancreas produces insulin, but it is insufficient for the body’s needs and its effectiveness decreases (type 2 diabetes).
Type 2 diabetes is connected with factors associated with a Western lifestyle, the condition is most common in people who are overweight.
In type 2 diabetes, the ability to produce and produce insulin by the insulin-producing beta cells of the pancreas is impaired. Scientists and doctors have constantly believed that these cells stopped working for good, but research shows that some cells can recover and function as usual again.
People who lose weight have lower levels of fat deposited in the liver and pancreas, and for some who lose weight, beta cells in their pancreas recover. The probability of saving beta cells is highest early in the disease, with advanced type 2 diabetes no insulin remains in the insulin reserves in the beta cells, advanced type 2 diabetes is more similar to type 1 diabetes along with insulin resistance.
Symptoms of diabetes
Typical symptoms of diabetes include
- Increased thirst.
- Frequent urination.
- Fatigue (you feel very tired).
- Weight loss, although appetite often increases (especially in type 1 diabetes).
- Itching, especially around the genitals.
- Recurrent skin infections.
- Acanthosis nigricans
How to deal with diabetes?
Diabetes is treated in two ways: a combination of healthy eating and exercise and/or medication with tablets, insulin injections or other injection therapy. A well-balanced diet containing very little calories is important for controlling body weight.
There are different types of tablets that are used in the treatment of type 2 diabetes. Some of these treatments increase the amount of insulin secreted by the pancreas. Other drug treatments enhance the effect of insulin in the body, and others delay the absorption of glucose from the digestive system.
Treatment of diabetes depends on the individual and is therefore tailored to each person with diabetes. Insulin injections are used in type 1 diabetes and in some cases type 2. Treatment with insulin injections increases the amount of insulin in the body and thereby lowers blood sugar levels.
What are the complications of diabetes?
Diabetes is a disease that requires a lot of self-treatment, individuals with diabetes need to undergo several routine check-ups annually at doctors. Monitoring blood glucose levels is an important part of treatment, especially in type 1 diabetes, where levels can change rapidly. In case of type 2 diabetes, it is also important to control factors such as smoking, high blood pressure, central abdominal obesity and blood lipids.
Blood glucose measurements are easily done at home with a small blood glucose meter, and depending on the reading, you may need to adjust your diet, the amount you exercise or your insulin intake. The purpose of regular blood glucose measurements is to determine if treatment is satisfactory and to look out for signs associated with increases the risk of complications. Insufficient risk factor control leads to an increased risk of feared complications such as heart attack, stroke, heart failure, eye or kidney disease.
More: Diabetes complications.
The importance of glucose control
Studies have shown that optimal blood sugar control can reduce or even prevent future complications. Type 2 diabetes is associated with four to five times increased risk of heart attack, stroke and heart failure, compared with people without diabetes. High blood sugar (hyperglycaemia) appears to be the main or among the main risk factors for heart attack and stroke. It is of the utmost importance to constantly control their risk factors, especially blood sugar levels, good blood sugar control leads to less atherosclerosis of your blood vessels.
How to reduce the risk of future complications?
Quit smoking: Smoking cessation is extremely important because it is a powerful risk factor for heart attacks and strokes. Even passive smoking leads to an increased risk of complications.
Diet: Reduce the intake of carbohydrates and refined sugar in your diet.
Blood pressure control: Check your blood pressure regularly and treat if it is high.
Check cholesterol levels: Find out what your cholesterol level is and make sure to reduce blood fats if they are elevated, a lean diet and more exercise can contribute to lower blood fats.
Lose weight: If you are overweight, it’s time to lose weight. Weight loss is probably the best way to reduce the risk of developing diabetes or reversing type 2 diabetes early in the course of the disease. Waist circumference is especially important because central abdominal obesity is a strong risk factor for diabetes.
Training: Exercise contributes to weight loss and has several other positive effects. In addition to weight loss, other metabolic factors such as blood sugar, blood pressure and blood lipids are also improved.
Is it possible to reverse diabetes?
In most cases, it is not possible to reverse diabetes, especially if you have type 1 diabetes. Individuals with type 1 diabetes have total insulin deficiency while some people with type 2 diabetes have a relative insulin deficiency. In advanced type 2 diabetes, the individual has lost the ability to produce and release sufficient amounts of insulin, which makes it impossible to reverse the condition. In some cases, however, it is possible to reverse the condition, including those with newly onset type 2 diabetes, pre-diabetes or reduced sugar tolerance.
Several studies suggest that blood sugar levels in type 2 diabetes can be normalized with a diet based on very low calorie. Carbohydrate poor diets can lead to significant weight loss, reduce insulin resistance, and in some cases reduce or even eliminate the need for diabetes medication altogether.
What is low-calorie diet?
A very low-calorie diet means that the person does not eat more than 800kcal/day, in which about 600 calories consist of liquid meals (for example, shakes) and the rest of non-starchy vegetables. This is an intensive food regime and an extreme form of slimming, the method should never be considered without consulting a doctor first. This method of slimming is also practically impossible to complete in the long term (several months or years).
A study from Newcastle examined the effect of very low-calorie diets, they observed that blood sugar levels in people with diabetes improved significantly, several could pause the use of antidiabetic drugs. The study also used MRI to investigate changes in the liver, since diabetes is linked to increased fat deposits in the liver and pancreas. The MRI study showed in this study that a very low-calorie diet significantly reduced fat deposits in the liver. A low-calorie diet could reduce fat levels in the liver, thus reversing fat deposits.
Because it is so challenging to adhere to a very low-calorie diet, some experts recommend reducing your calorie intake to 1200-1500 kcals/day along with at least 175 minutes of aerobic exercise per week. This should lead to weight loss, slow the progression of the pathological condition and in some cases reverse type 2 diabetes.
Research studies investigating this type of issue have noticed that people who manage to reverse diabetes also have very easy to develop rising blood sugar levels and symptoms in the future if they misbehave.
Exercise and physical activity
Exercise improves several factors in diabetes, but it can be difficult to lose enough weight to go in remission with exercise only. Increased exercise should be combined with improved diets.
One study examined the effect of walking 10,000 steps a day and at least 2.5 hours of exercise a week with moderate intensity along with low-calorie diet (500-750 calories per day). They noted that half of the study participants had normal blood sugar without medication at the end of the study period. Several of the study participants were able to maintain normal blood sugar levels for a longer period.
Read the chapter on the relationship between physical activity and diabetes
Summary: It is weight loss that really matters. Exercise can help you lose weight and improve several metabolic factors, but you probably also need to improve your diet habits to lose weight and maintain a normal weight.
Obesity surgery (bariatric surgery)
Obesity surgery is a kind of surgery that will help you lose weight by changing the interconnection of the gastrointestinal tract. There are several surgical methods that vary in efficacy and side effect profile. The most common operations lead to narrowing of the gastrointestinal tract, which means that food passes a shorter distance before reaching the large intestine. Relaxing the gastrointestinal tract also affects the hormones released in the intestine, these hormones help the body control blood sugar.
Research shows that almost three-quarters of all people with type 2 diabetes undergoing bariatric surgery can reverse their diabetes, especially if it is early in the course of the disease.
Bariatric surgery is generally only an option when BMI is 35 or higher. It works best for people who have had the disease for 5 years or less and do not use insulin.
If you are overweight and recently diagnosed with diabetes, you can discuss with your doctor the possibilities of obesity surgery. Since it is surgery, there are serious risks, but most people who undergo the procedure often manage to reverse their diabetes.
Fasting can be a practical way to lose weight because it is quite simple, but it is not a common treatment for type 2 diabetes.
A very small study found that therapeutic fasting, therefore, no food and drink for a certain period of time, can help you reverse type 2 diabetes. Three people with diabetes followed a diet program with three days fasting every week, for several months. They ate dinner only on days they fasted, and lunch and dinner on days they do not fasten, with a low carbohydrate content in meals.
Two of the people in the study could stop taking all antidiabetic drugs, and the third could stop taking three of his four medications. Within 1-3 weeks, all three could stop taking insulin. They lost between 10% and 18% of their body weight.
Another study showed that eating few calories (500-600) 2 days a week and a normal diet the other days helped people with type 2 diabetes lose weight and lower blood sugar levels as much as limiting calories to 1,200-1,500 every day.