Tuesday, May 28, 2013

Can You Reverse Type 2 Diabetes?

By Sonya Collins
WebMD Feature

The idea of "reversing" type 2 diabetes through lifestyle changes is appealing.

It's true that exercise and healthy eating habits should be a part of every diabetes treatment plan and can make a big difference. But there's more to it than that.

Sometimes those habits will turn your diabetes around, but this depends on the severity of the disease, how long you've had it, and your genes.

It's a myth that type 2 diabetes is only about lifestyle or obesity.

True, most people with type 2 diabetes are overweight or obese, but thin people can get type 2 diabetes, too.

Also, "not everybody with obesity gets diabetes. The ones that get it have a genetic predisposition," said Yehuda Handelsman, MD, a past president of the American Association of Clinical Endocrinologists.

It's not just your genes, or just your lifestyle, that counts. They both matter and affect each other.

"The saying goes that genes load the gun and lifestyle pulls the trigger," says Ann Albright, PhD, RD, director of the CDC's division of diabetes translation.

Because of that connection between genes and lifestyle, diet and exercise alone aren't a guaranteed "cure" for everyone with type 2 diabetes.  

What you mean by "reversing" type 2 diabetes also matters. If it means you no longer need medication to control your blood sugar, that's possible with hard work and dedication.

However, if you mean undoing any and all damage that diabetes did to your body, that may be less likely.

Of course, there's no downside to trying, and a lot of potential benefit. Just keep your goals realistic because you need to make those changes last.

Losing extra weight can help you better control your blood sugar. For some people, this will mean taking fewer medications, or, in rarer cases, no longer needing those medications at all.

It needs to be a permanent change.

"The term ‘reversal' is used when people can go off medication, but you still must engage in a lifestyle program in order to stay off the medication. That is a part of treatment," Albright says.

Experts recommend losing 5% to 10% of your body weight and building up to 150 minutes of exercise per week to try to slow or stop the progress of the disease.

If you're not even close to that amount of exercise, start where you are and build up.

"If you sit sedentary most of the day, five or ten minutes is going to be great," Albright says. "Walk to your mailbox. Do something that gets you moving, knowing that you're looking to move towards 30 minutes most days of the week."

In one study, people with type 2 diabetes exercised for 175 minutes a week, limited their calories to 1,200 to 1,800 per day, and got weekly counseling and education on these lifestyle changes. Within a year, just over 10% were able to get off their diabetes medications or improved to the point where their blood sugar level was no longer in the diabetes range, and was instead classified as prediabetes. 


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