Advances in drug treatment and management options for type 2 diabetes have come a long way, but diabetes remains a major chronic health problem. Recent studies have shown that although there is no cure for type 2 diabetes, it might be possible to reverse its course or place it in remission through diet change and weight loss.

A number of studies indicate that type 2 diabetes reversal is achievable using bariatric surgery (gastric bypass and other weight-loss surgeries), while other studies show the effectiveness of non-surgical techniques such as low-calorie diets (LCD) or carbohydrate restriction (LC).

Low-Calorie Diets (LCD)
Studies show that a low-calorie diet may be effective in reversing diabetes. The studies highlight the importance of starting on a weight loss plan as soon as possible after diagnosis to get the best results.

An extreme low-calorie diet isn’t for everyone because it requires an intense period of time (usually a few months) where you restrict your calorie intake to just600-850 kcal a day. After this period, you slowly re-introduce normal, healthy food again.

Because a very low-calorie diet can lead to a variety of health problems it is important you talk to your doctor before starting on one, so you can be sure it is safe for you.

Low-carbohydrate diets (LC)
Low-carbohydrate diets of less than 130 grams of carbohydrate a day have been endorsed by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) as being beneficial in regulating blood sugar and potentially reversing type 2 diabetes.

This type of diet, also known as a ketogenic diet, appears to offer major improvements in glycemic control and medication reduction for type 2 diabetes.

Bariatric Surgery
When lifestyle changes like diet, exercise, and medication have proven ineffective in losing weight, bariatric surgery may be an alternative option. The term ‘bariatric surgery’ covers procedures such as gastric bypass and other weight loss surgeries. These procedures work in a number of ways, from restricting the amount of food your stomach can hold, to reducing the body’s ability to absorb nutrients, or a combination of the two.

Type 2 diabetes reversal rates following bariatric surgery have been reported to be as high as 80%, with an additional 15% demonstrating partial improvement while still requiring medication.

Bariatric surgery has been demonstrated to be safe and effective overall, but it is important to recognize that, as with any major surgery, it is associated with risks like:

  • Operation complications like leaks into your gastrointestinal system.
  • Post-operative hypoglycemia – hypo-glycemia two hours after a meal, probably due to increased insulin sensitivity after surgery.
  • Dumping syndrome – nausea, unpleasant fullness, abdominal cramps, diarrhea, weakness, sweating.
  • Acid reflux – acid in the stomach rises to cause a feeling of “burning” or pain in the center of the chest.
  • Malnutrition – reduced absorption may cause nutritional deficiencies.
  • Some people may still experience weight regain and/or recurrence of comorbid obesity-associated conditions.

Reversing diabetes is currently not the main goal in diabetes management, but the large increase in the rate of diabetes is leading to the examination of additional treatment options to prevent or delay the condition.

Bariatric surgery is the most effective method for overall efficacy and prolonged remission, despite concerns associated with surgical complications. Both the low calorie and low carbohydrate dietary approaches are beneficial for short-term (up to two years) diabetes reversal, but long-term reversal has not yet been proven.

Whichever way you manage your diabetes, monitoring your blood glucose and weight using the Dario app will help you and your doctor check your progress and consider changes to your treatment.