Can diabetes be reversed? Experts explain what really works in long term

Beyond crash diets and fads, doctors say diabetes remission is driven by realistic lifestyle changes, early action and consistency, not extreme workouts or quick fixes

For years, people living with type 2 diabetes have been told that reversal requires extreme diets, punishing workouts or dramatic weight loss. But growing evidence and clinical experience suggests that diabetes remission is possible through sustained, realistic lifestyle changes, not short-term extremes.

 

Doctors now emphasise that the goal is not perfection, but consistency. And for many, improvement begins much earlier than expected.

 

What does diabetes “reversal” actually mean?

 

In medical terms, diabetes reversal is better described as remission. “Diabetes remission refers to maintaining blood glucose levels close to normal without glucose-lowering medications for a sustained period,” explains Dr Manoj Chawla, Consultant Diabetology at P D Hinduja Hospital & MRC, Khar.

 

 

He adds that the word “reversal” is not scientifically precise because diabetes can recur if lifestyle changes are not maintained. Partial remission is defined as HbA1c below 6.5 per cent without medication, while complete remission requires HbA1c below 5.7 per cent. Long-term remission means sustaining these levels for five years or more.

 

According to Dr Gagandeep Singh, Founder of Redial Clinic, clinical remission often means “maintaining HbA1c below 5.5 per cent for at least three months after stopping all glucose-lowering medicines”. He notes that people diagnosed early, with preserved beta-cell function, have the highest chance of success, though even long-standing diabetes can improve with sustained effort.

 

Why crash diets and extreme workouts fail

 

While rapid weight loss may look impressive initially, it rarely addresses metabolic health. “Most fad diets perform their work of failure within six to twelve months,” says Dr Chawla. Rapid loss often reflects water and glycogen depletion rather than the critical reduction of liver and pancreatic fat, which quickly returns once normal eating resumes.

 

Dr Singh says, “Your body is smarter than your willpower.” Severe calorie restriction slows metabolism, increases hunger hormones and promotes weight regain. Extreme exercise without adequate nutrition also raises cortisol, which worsens insulin resistance. Over time, this cycle damages metabolic health rather than restoring it.

 

What can actually help

 

1. Early and sustained weight loss

Remission is closely linked to losing 10–15 per cent of body weight, particularly early in the disease. Landmark trials like DiRECT show that reducing fat in the liver and pancreas restores insulin function.

 

2. Smarter carbohydrates, not zero carbs

Refined carbohydrates such as sugar, maida, white rice and bakery foods drive glucose spikes. Doctors recommend lower-glycaemic options like millets, oats, barley, pulses and non-starchy vegetables.

 

3. Adequate protein intake

Protein preserves muscle mass during weight loss and improves satiety and post-meal sugar control. Sources include dals, paneer, curd, eggs, fish, soy, nuts and seeds.

 

4. Better fats, fewer ultra-processed foods

Healthy fats from mustard oil, groundnut oil, olive oil, nuts and seeds support metabolic health. Trans fats and ultra-processed foods should be limited.

 

5. Eating timing matters

Early dinners, avoiding constant snacking and, for some, time-restricted eating within a 10–12 hour window can improve insulin sensitivity.

 

6. Choose sustainable diet patterns

Very low energy diets (800–1200 kcal) may help short-term when medically supervised. Mediterranean-style diets and moderate low-carbohydrate plans show strong long-term evidence. “There is no single diet that works for everyone,” Dr Chawla stresses. “Personalisation determines success.”

 

The overlooked pillars - sleep, stress and daily movement

 

Blood sugar control does not come from the gym alone. Poor sleep and chronic stress raise cortisol levels, driving insulin resistance. “You can’t outrun a sleep debt,” says Dr Singh.

 

Daily movement, walking after meals play a powerful role. A 15-minute post-dinner walk can reduce glucose spikes by up to 30 per cent. Structured exercise matters, but only after sleep, stress and daily activity are addressed.

 

How soon can improvement begin?

 

“Improvement starts almost immediately,” says Dr Singh. Early signs often appear within weeks. Falling fasting glucose, fewer post-meal spikes and reduced medication needs are common. Continuous glucose monitoring shows smoother daily curves instead of sharp peaks.

 

Medication reduction may follow within three to six months, and remission is possible within six to twelve months for those who start early and remain consistent.

 

Experts say diabetes remission is not about extremes. It is about realistic changes, repeated daily and sustained for life. 

Also read: Ten diabetes-friendly grains to steady blood sugar and support weight loss

 

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This report is for informational purposes only and is not a substitute for professional medical advice.