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Can Type 2 Really Be Reversed?

9 min read

The standard approach treats high blood sugar with medications while ignoring what caused it: chronically high insulin. A different approach—addressing the root cause—achieves remission rates up to 46% in real-world settings. Here's the evidence most doctors never see.

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If you've been diagnosed with Type 2 Diabetes, you were likely handed a heavy message: this is a chronic, progressive condition—a one-way street of increasing medications and fear of complications.

That message leaves you feeling helpless.

But here's something many doctors don't tell you—often because they were never taught it: the "progressive" nature of Type 2 is only true when you keep eating the way that caused it.

For many people, reversing Type 2 diabetes isn't a distant hope. It's an achievable reality—backed by growing evidence that challenges decades of medical dogma.

Remission means returning your blood sugar to normal (below 6.5% HbA1c) without diabetes medications. Not just "managing" diabetes better—actually putting it into remission.

This is life-altering information. And it means you have more power than you've been told.

The Real Problem Nobody Talks About

Walk into most doctor's offices with Type 2, and the conversation centers on one thing: your blood sugar number.

High blood sugar becomes the enemy. You get medications to push it down. More medications when those stop working. Eventually, maybe insulin.

But here's what they're missing: Type 2 diabetes is fundamentally a disease of too much insulin.

Think of it this way:

Your body is a rain barrel. Sugar from food is water pouring in. The barrel represents your storage capacity. Pour in too much, the water spills into your bloodstream—that's the high blood sugar everyone focuses on.

But here's what matters more: how much insulin your body is producing to try managing all that sugar.

Why Insulin Matters More Than You Think

Insulin is the hormone that moves sugar from your bloodstream into cells. It's like a key that unlocks cell doors.

When you constantly eat foods that spike your blood sugar (bread, pasta, rice, sweets), your cells eventually stop listening. The locks jam. This is called Insulin Resistance.

Your body responds by making more and more insulin to move the same amount of sugar.

This leads to chronically high insulin—often years before your blood sugar tests show diabetes.

And here's what nobody tells you: high insulin causes serious problems:

  • It locks fat in storage. Insulin actively blocks fat burning, making weight loss nearly impossible
  • It drives Inflammation throughout your body—damaging blood vessels, nerves, organs
  • It worsens the cycle. More carbs → more insulin → more resistance → higher blood sugar → more medications → even more insulin
  • It affects your whole life: reduced sex drive, erectile dysfunction, PCOS (making it harder for women to get pregnant), cognitive decline, and increased dementia risk

Conventional treatment often makes this worse by adding medications that force even higher insulin production while you continue eating the foods that caused the problem.

This Actually Works—Here's the Proof

The research showing remission is possible exists—but it's not part of standard medical training.

Medical schools teach doctors how to prescribe medications, not nutritional therapy. Guidelines take years to change. And most doctors are too overworked to keep up with emerging research.

This doesn't mean your doctor is holding back. It means the system is slow to adapt.

But the evidence is there.

Real Results from Real People

A UK doctor's office, 2013-2019: They simply told patients to reduce sugary and starchy foods, with brief appointments and optional support groups.

Among people with Type 2 diabetes: - 46% achieved drug-free remission - Average blood sugar dropped from diabetic (65.5) to normal (48) - Average weight fell from 99.7 kg to 91.4 kg - Even those with terrible blood sugar control saw dramatic improvement

Among people with prediabetes: 93% returned to normal blood sugar.

This wasn't fancy research. Just regular doctors and nurses in everyday practice.

Over five years: People following very low-carb eating with remote coaching: - 20% maintained full remission at five years - Another 33% reached normal blood sugar with only basic medication or none - Weight stayed down (average 19 lbs lost) - Insulin use cut in half - Inflammation markers dropped 44%

And 72% stuck with it for all five years—proving it's sustainable with proper support.

In just 12 weeks: Practice nurses supporting people on a low-carb approach saw: - Average weight loss of 21 lbs (versus 4 lbs in usual care) - Blood sugar improvements equivalent to 1.5% HbA1c drop - Seven people stopped diabetes medications - Seven stopped blood pressure medications

In three months. With four short appointments and a booklet.

What About Heart Health?

A comprehensive review of all the research found: - Low-carb improves blood sugar as much or more than other approaches - Medications drop faster—often needing immediate adjustment - triglycerides fall; HDL (good Cholesterol) rises - No evidence of increased heart disease risk—even when people eat more fat

For decades we were told fat causes heart disease. The research doesn't support that fear.

How It Works: Lower the Sugar, Lower the Insulin

The strategy is straightforward:

Stop flooding your body with foods that spike blood sugar.

When you dramatically reduce carbohydrates—especially refined sugars and starches—several things happen:

  1. Less sugar enters your bloodstream
  2. Your body needs far less insulin
  3. Low insulin allows your body to switch from storing fat to burning it
  4. Your cells begin healing from insulin resistance

The Power of Very Low-Carb (Ketogenic) Eating

While any reduction in carbs helps, very low-carb or ketogenic eating has the most dramatic results.

Why? Because it triggers a fundamental metabolic shift: your body switches from burning sugar as its primary fuel to burning fat. This is called Ketosis—and it's a natural state your body is designed for.

In ketosis: - Your insulin drops to healthy levels - Fat burning accelerates - Hunger decreases naturally - Energy becomes stable throughout the day - Inflammation drops significantly

The five-year study mentioned above used ketogenic eating—and achieved 20% full remission with 72% of people sticking with it for years.

That said: Any reduction in carbs helps. Even if you're not ready for full keto, cutting back on bread, pasta, rice, and sweets will reduce your insulin burden and begin the healing process. Start where you can. You can always go further later.

Want to know what to actually eat? See our guide: What to Eat on a Ketogenic Diet

"But Isn't Fat Bad for My Heart?"

If you're thinking about cutting carbs, you're probably wondering: "Won't I have to eat more fat? Isn't that dangerous?"

For decades, we were told fat—especially saturated fat—causes heart disease.

The research doesn't support this fear.

Recent reviews of all available studies find no link between saturated fat and heart disease death. The real risk factors for heart disease? High blood sugar and high insulin—exactly what we're fixing.

When you reduce carbs, your body uses fat for fuel instead of storing it. The five-year study showed stable cholesterol levels despite people eating low-carb for years—while their inflammation dropped dramatically.

Your Heart Health improves because you're fixing the root problem: insulin overload.

You Can Do This

Let's be clear about what's at stake.

Uncontrolled Type 2 diabetes is the third leading cause of death in the United States. It drives heart disease, stroke, kidney failure, blindness, amputations, sexual dysfunction, and dementia.

But you're not doomed.

The most important step: change what you eat.

This isn't just about avoiding complications. It's about securing freedom: - Freedom from constant hunger and cravings - Freedom from escalating medications - Freedom from fear of complications - Freedom to live fully

The Critical Safety Note

Because carb reduction works so effectively, it can be dangerous if you're taking diabetes medications—especially insulin or sulfonylureas.

Blood sugar can drop rapidly, requiring immediate medication adjustments to prevent dangerous lows.

You need medical supervision. Work with a healthcare provider who understands low-carb approaches. If your current doctor isn't familiar with this approach, you may need to find someone who is—or share the research with them. Many doctors are open to new evidence when they see it.

For detailed guidance on safe transitions, see: Safety First: Medical Supervision for Keto Transitions

Getting Started

The approaches that worked in these studies shared common elements:

  • Dramatic reduction in refined carbs: bread, pasta, rice, sweets, sugary drinks
  • Focus on real, whole foods: meat, fish, eggs, non-starchy vegetables, healthy fats
  • Regular monitoring of blood sugar and other markers
  • Medication adjustment as blood sugar improves
  • Ongoing support—which brings us to the most important factor...

Support Makes All the Difference

Very few people succeed alone. The most powerful support? Your family.

When your household embraces lower-carb eating together, everything becomes easier. No separate meals. No temptation in the cupboards. Shared commitment.

And here's the good news: low-carb eating is healthy for everyone—not just people with diabetes. Your family benefits too.

Beyond family, consider: - Healthcare providers knowledgeable about low-carb approaches
- Support groups (in-person or online) - Educational resources like this site - Coaching programs if you need more structure

The research shows people who stick with it have support systems. Build yours before you start.

Making Changes That Last

Here's what none of the studies fully capture: lasting change is hard.

The research proves it's possible. The outcomes speak for themselves. But knowing what to do and actually doing it day after day are different challenges.

If you struggle to make changes stick, that's normal. It's not a personal failing. Change is difficult.

Be patient with yourself. Start where you can. Seek support. Keep learning.

Small, sustained changes beat dramatic starts that don't last.

The Truth About Type 2

Type 2 diabetes doesn't have to be progressive. The path of increasing medications and declining health is not inevitable.

Multiple studies—from controlled trials to real-world doctor's offices—show that remission is possible for many people.

The key: addressing the root cause (too much insulin) rather than just treating the symptom (high blood sugar).

This requires: - Reducing the foods that spike blood sugar - Proper medical supervision for medication adjustments - Support (especially from family) - Sustained commitment

It's not easy. But it's possible.

The science is on your side. Your body is ready to heal.

The question is: are you ready to start?

References

  1. Riddle MC, Cefalu WT, Evans PH, et al. Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes. Diabetes Care. 2021;44(10):2438–2444.

  2. Alison B. Evert, Michelle Dennison, Christopher D. Gardner, W. Timothy Garvey, Ka Hei Karen Lau, Janice MacLeod, Joanna Mitri, Raquel F. Pereira, Kelly Rawlings, Shamera Robinson, Laura Saslow, Sacha Uelmen, Patricia B. Urbanski, William S., Jr. Yancy. (2019). "Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report". Diabetes Care, 42(5), 731-754. https://doi.org/10.2337/dci19-0014.

  3. Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018;391(10120):541–551.

  4. David Unwin, Ali Ahsan Khalid, Jen Unwin, Dominic Crocombe, Christine Delon, Kathy Martyn, Rajna Golubic, Sumantra Ray. (2020). "Insights from a general practice service evaluation supporting a lower carbohydrate diet in patients with type 2 diabetes mellitus and prediabetes: a secondary analysis of routine clinic data including HbA1c, weight and prescribing over 6 years". BMJ Nutrition, Prevention & Health, 3(2), 285-294. https://doi.org/10.1136/bmjnph-2020-000072.

  5. A L McKenzie, S J Athinarayanan, Van Tieghem MR, B M Volk, C G Roberts, R N Adams, J S Volek, S D Phinney, S J Hallberg. (2024). "5-Year effects of a novel continuous remote care model with carbohydrate-restricted nutrition therapy including nutritional ketosis in type 2 diabetes: An extension study". Diabetes research and clinical practice, 217. https://doi.org/10.1016/j.diabres.2024.111898.

  6. Elizabeth Morris, Paul Aveyard, Pamela Dyson, Michaela Noreik, Clare Bailey, Robin Fox, Derek Jerome, Garry D Tan, Susan A Jebb. (2020). "A food-based, low-energy, low-carbohydrate diet for people with type 2 diabetes in primary care: A randomized controlled feasibility trial". Diabetes, Obesity and Metabolism, 22(4), 512-520. https://doi.org/10.1111/dom.13915.

  7. Sean D Wheatley, Trudi A Deakin, Nicola C Arjomandkhah, Paul B Hollinrake, Trudi E Reeves. (2021). "Low Carbohydrate Dietary Approaches for People With Type 2 Diabetes—A Narrative Review". Frontiers in Nutrition, 8. https://doi.org/10.3389/fnut.2021.687658.

  8. Richard D. Feinman, Wendy K. Pogozelski, Arne Astrup, Richard K. Bernstein, Eugene J. Fine, Eric C. Westman, Anthony Accurso, Lynda Frassetto, Barbara A. Gower, Samy I. McFarlane, Jörgen Vesti Nielsen, Thure Krarup, Laura Saslow, Karl S. Roth, Mary C. Vernon, Jeff S. Volek, Gilbert B. Wilshire, Annika Dahlqvist, Ralf Sundberg, Ann Childers, Katharine Morrison, Anssi H. Manninen, Hussain M. Dashti, Richard J. Wood, Jay Wortman, Nicolai Worm. (2015). "Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base". Nutrition, 31(1), 1-13. https://doi.org/10.1016/j.nut.2014.06.011.

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