How to reverse Diabetes? Is it completely curable?

Through diet and weight loss, one can achieve normal blood glucose levels without any medication. Diet plays a pivotal role in controlling high blood glucose. As per research studies, bariatric surgery, carbohydrate restriction, and low-calorie (LC) diets have all been effective in reversing type 2 diabetes. In recent years, the LC eating pattern has gained support from the European Association for the Study of Diabetes (EASD) and the American Diabetes Association (ADA) for its ability to help people with diabetes achieve and maintain a healthy weight in the short term.

Yes, type 2 diabetes can be kept under remission (blood sugar levels can be in control) with no more intake of oral medication or insulin. The remission chances will be more if the patient starts losing weight (healthy weight loss) as early as the diagnosis of type 2 diabetes. Scientists believe that the development of type 2 diabetes is influenced by fat storage in the liver and pancreas, and thereby reducing body fat can help in diabetic remission.

A diet rich in minerals,  fibre, and vitamins can aid in the provision of diabetic reversal, such as 

• Green leafy vegetables (spinach), which are low in carbohydrates, glycaemic index, and rich in nutrients, aid in managing high blood sugar levels.
• Whole grains (brown rice, whole oats etc.), which are rich sources of fibre with a low glycaemic index, aid in the maintenance of blood sugar levels. In addition, these also consist of vitamins and minerals, which act as cardioprotective.
• Nuts comprise fibre, protein, and healthy fats. According to a recent study, consuming nuts may decrease the risk of cardiovascular disease in people with diabetes.
• Inclusive fruits with low glycaemic index and low glycaemic load (cherries, blackberries, apple and vitamin C-rich foods like grapefruits, tangerines, and oranges that comprises high levels of potassium and folate) in daily diet is highly advisable. Consuming fruit should be preferred over fruit juice, as the fibre present in the fruit helps in the prevention of sugar spikes.
• Beans consist of fibre, vitamins and proteins without saturated fat. As per studies, beans are a good source of a low glycaemic diet, thereby controlling high blood sugar levels.
• Dairy products, Vitamin D, found in dairy products, may improve insulin sensitivity. They also contain calcium, which is beneficial for bone health. Low-sugar varieties of yoghurt should be preferred in order to avoid Carbs.
• Omega-3-rich fatty fishes (tunas, salmon, mackerel etc.) that aid in lowering inflammation, thereby protecting from diabetic retinopathy
• Sweet potatoes. For people with diabetes, sweet potatoes can be handy in maintaining healthy eyes due to their high vitamin A and fibre content.

Yes, walking more can aid in controlling high blood sugar levels. Aerobic exercise includes walking, especially at a brisk pace or with moderate intensity (30 to 60 minutes), have numerous positive effects on health, such as 

• Reduction in blood sugar levels, low-density lipoprotein cholesterol, and blood pressure
• Increase in insulin sensitivity, metabolism, and high-density lipoprotein cholesterol
• Improves cardiac function
• Weight loss

In type 2 Diabetes, exercise leads to an increase in insulin sensitivity. As per a research study, there was no change in blood glucose concentrations in patients who were fasting, but there was a decrease in blood sugar concentrations in patients who exercised after a meal.

The reversal rate of diabetes is directly proportional to the amount of weight loss. In a study conducted on the Indian diabetic population (newly diagnosed) where all the patients were treated with a low-calorie diet (<1500 kcal/day) and one hour of brisk walking per day. 53.1% had achieved complete reversal, and 7% achieved partial reversal at three months, followed by 50 % and 25% at one year and 46.9% and 21.9% at two years, respectively.

It depends on the patient's condition and their capability to reduce body weight. There is no exact number (age or duration of diabetes) at which a diabetic patient can reverse their condition. However, studies have shown patients with 25 years of diabetic history have reversed their diabetic condition by losing weight. 

Yes, a diabetic patient with HbA1c 6.5% is reversible with the aid of lifestyle modification (daily exercise and diet), considering a patient with no associated diabetic complications. 

The fastest way to reverse diabetes is by following the below-mentioned:

• Healthy reduction of body weight upto15 kgs in case of obese
• Daily 30 to 60 minutes of moderate-intensity aerobic exercise
• Intake of a diet rich in fibre and low in carbohydrates
• Consumption of more water and being hydrated all the time
• Strict adherence to prescribed medication
• Abstain smoking
• Maintain good sleep hours

As per a study in India, all patients with type 2 DM included in the study with associated body mass index (BMI) of less than 35 kg/m2 reversed their diabetes within three months after undergoing the Roux-en-Y Gastric Bypass procedure.

One can prevent the diabetic condition from the prediabetic stage by adhering to the following:

• Moderate weight loss (5 to 7% of body weight)
• 150 minutes of brisk walking in a week or half an hour a day (for five days a week)

As per the Centers for Disease Control & Prevention (CDC) report, participants in lifestyle change programs recognised by the CDC who lost 5-7 % of their body weight and increased their weekly exercise time to 150 minutes had shown a 58% decrease in developing type 2 diabetes risk, among which 71 % are of over 60 years old.

The five rules of diabetes control are as follows:

• Intake of a healthy diet
• Exercise regularly
• Intake of appropriate medications
• Regular glucose check-ups
• Education about diabetes