The Digest

Overview

Being diagnosed with Type 2 diabetes can cause your mind to flood with questions.

• What exactly is Type 2 diabetes—and what does it mean for your long term health?
• Can Type 2 diabetes can be reversed or cured? 

The short answer to the latter is "yes!" Type 2 diabetes can—in some cases—be reversed. 

To do so, however, it’s important to understand how Type 2 diabetes arises and what methods of reversal have been shown to be effective and safe. 

Note: If you’ve been diagnosed with Type 2 diabetes and are looking for a natural, clinically-backed way to help manage your A1C levels, we can help. Pendulum Glucose Control, however, is not intended to cure Type 2 diabetes or replace drug therapy recommended by your doctor or health care professional.

What is the root cause of Type 2 diabetes?

Diabetes is a condition where a person’s body has trouble controlling its blood-sugar levels.

Typically, a person’s body is able to keep blood-sugar levels within a tight range, ensuring that they never dip too low or spike too high—at least not for too long.

This is largely done by using a hormone known as insulin^1,2.

Insulin is a hormone that’s produced in the pancreas. Shortly after eating a meal, the bloodstream is flooded with sugars that were extracted from the newly digested food. 

Once in the bloodstream, the sugar is rushed throughout the body via a network of blood vessels so that any cell in need of energy can just pluck the sugar out of the bloodstream and use it as fuel (sugar is one of the body’s most important fuel sources). 

However, many cells can’t sense sugar on their own. They need some help knowing when sugar is present. 

That’s where insulin comes into play.

As blood-sugar levels rise, cells in the pancreas—known as beta cells—sense the rising tide of sugar. They respond by dumping insulin into the bloodstream where it too is rushed around the body.

While many cells can’t sense sugar, they can sense insulin thanks to a special protein that sits on the cells’ surface. This protein, known as insulin receptor, can latch onto insulin as it flows past the cell. 

Once the two meet, a chain reaction is triggered within the cell and it can then take sugar in from the bloodstream to use as fuel or store for later use. 

When blood-sugar levels increase, so too do insulin levels. As a result, cells begin to remove sugar from the blood. This removal causes blood-sugar levels to decrease.

To prevent it from decreasing too much, the body recognizes falling levels of blood sugar and stops releasing insulin. 

This is how blood-sugar levels are usually controlled by the body, and both researchers and physicians refer to it as insulin signaling. 

But if you have diabetes, it means something in your body’s insulin signaling has stopped working as well as it should.

Exactly which part of insulin signaling isn’t working as well as it should depend on the type of diabetes you have. 

If it’s Type 2 diabetes, it means that cells in your body are not able to respond to insulin as well as they should.

In response to rising blood-sugar levels, insulin is released but cells are either unable to sense the rise in insulin levels, or their response to it isn’t very strong.

This is known as insulin resistance.

In either case, the end result is the same: 

Cells fail to take in the right amount of sugar from the blood and blood-sugar levels remain high^1,2,3. 

What happens if Type 2 diabetes is left untreated?

If Type 2 diabetes is left untreated, it can lead to (among other complications):

Even though sugar is an important fuel source for the body, chronically high blood-sugar levels can cause a buildup of byproducts that are made when cells break down or use the sugar (in some ways, this is similar to the production of CO2 after burning gasoline). 

These byproducts can be quite destructive. In small amounts, cells can neutralize them. But when blood-sugar levels are high and remain high for long periods of time, cells become overwhelmed and blood vessels become damaged⁵. 

The effects of damaged blood vessels can vary depending on where in the body the damage occurs. 

Blood vessels in the back of the eye are particularly susceptible to this kind of damage which is why many people with unmanaged Type 2 diabetes develop retinopathy (swelling of the retina) and the resulting vision loss⁵. 

Can diabetes go away on its own?

Diabetes does not go away on its own. 

Managing Type 1, Type 2, and other forms of diabetes can help you avoid serious health conditions associated with diabetes and—in some cases—may even help you reverse the disease’s course. 

However, this cannot happen on its own.

It will require deliberate action and consultation with healthcare professionals. 

Does Type 2 diabetes get worse with age?

The impact of Type 2 diabetes can get worse with age. 

If left unmanaged, Type 2 diabetes will get worse over time as the negative effects of high blood sugar start to compound on one another, leading to blood vessel damage and conditions like kidney disease and retinopathy^5,6. 

When managed, the impact of Type 2 diabetes may be minimized. However, as we age, several factors may lead to the progression of diabetes. 

For instance, the pancreas may lose some of its ability to release insulin over time, making it harder for the body to control blood-sugar levels. 

Additionally, physical activity may be harder to come by in elderly individuals, which may result in higher blood-sugar levels as well⁷. 

What is the lifespan of a person with Type 2 diabetes?

Even though it’s a difficult topic, it’s common to wonder what impact Type 2 diabetes might have on your lifespan. 

There is no concrete answer to this question because how Type 2 diabetes affects your long-term health is very dependent on several factors, including

• Your age at diagnosis
• Whether you have access to treatment, and
• What support resources are available to you

It is clear that—if left untreated—Type 2 diabetes can lead to early death often as a result of cardiovascular disease. 

In general, studies including people who were actively treating their diabetes concluded that Type 2 diabetes may reduce lifespan. 

One study involving millions of people in Scotland found that Type 2 diabetes ultimately reduced the average lifespan of individuals by ~5 years. 

It’s important to note that these conclusions may be population-specific, as some studies have observed differences between self-reported ethnicities^4,5.  

Can Type 2 diabetes be cured?

Type 2 diabetes cannot be cured in the medical sense of the word. 

Unlike short-term illnesses, such as bacterial infections, diabetes is a chronic condition with varying degrees of severity.

With treatment, the symptoms of Type 2 diabetes may go away entirely. However, over time, they may come back.

Because of this, researchers and physicians have concluded that Type 2 diabetes cannot be permanently cured^8,9. 

Don’t let that discourage you, though... 

While it can’t be cured in technical terms, Type 2 diabetes can be managed to the point where it is effectively cured. 

This is called long-term remission, or long-term reversal.

Can Type 2 diabetes be reversed?

There is ample evidence to suggest that—in some people—Type 2 diabetes can be reversed.

The reversal in this context means that the symptoms of Type 2 diabetes—high blood sugar—disappear without medication for an extended period of time. 

This would mean, for example, that your A1C levels are maintained below 5.7% for at least a year without the help of medication or ongoing surgeries⁹. 

Among physicians and researchers, reversal is often referred to as remission.

Research suggests there are at least two ways for people with Type 2 diabetes to go into remission: 

• Bariatric surgery and
• Strict diets that limit calories or carbohydrates 

Can Type 2 diabetes be reversed with weight loss?

Weight loss does appear to be an important predictor in managing and reversing Type 2 diabetes. 

Patients who manage to reverse Type 2 diabetes tend to stay in remission for longer periods of time if they lose excess weight and keep the weight off ⁹. 

One study, known as the Diabetes Remission Clinical Trial (DiRECT), enrolled 306 people with diabetes to study how intensive dieting, combined with long-term aid might affect measures of blood-sugar regulation (such as A1c=C levels).

After 2 years, the team found that 36% of participants had managed to maintain Type 2  reversal and that these participants tended to have less body fat after the study intervention. Further examination suggests that reduced body fat may be an important part of reversing Type 2 diabetes. Further research will be needed to confirm this finding¹¹.

It’s important to note that participants in the DiRECT study were following guidance from trained professionals. Weight loss should be guided by healthcare professionals to avoid harm from losing weight too fast or through unsafe methods. 

This is particularly important for individuals who are also trying to manage eating disorders.

How much weight do you need to lose to reverse Type 2 diabetes?

Because bodyweight is determined by a number of factors, including genetics, environment, and lifestyle, the amount of weight that can be safely lost varies from person to person. 

If you are considering weight loss as a method of treating Type 2 diabetes, you should work with your doctor or registered dietitian to determine weight loss goals that are right for your specific situation. 

Can bariatric surgery reverse Type 2 diabetes?

Bariatric surgery appears to be the most effective method for short-term and potentially long-term reversal of Type 2 diabetes⁹.

Results from multiple studies have found that bariatric surgery—the surgical alteration of the digestive tract—can lead to a short term reversal of Type 2 diabetes in approximately 80% of patients. 

Unfortunately, these procedures are less effective with long-term reversal, where approximately 37-45% of patients remain in remission five years after surgery⁹. 

Precisely why bariatric surgery is effective is not yet clear. There are multiple types of bariatric surgery which generally share the guiding principle of decreasing the volume of the digestive tract which can result in reduced consumption and reduced absorption of various nutrients.

Research on the use of bariatric surgery for the treatment of Type 2 diabetes has shown that the procedure itself appears to have a positive effect on reducing Type 2 diabetes symptoms in addition to benefits gained from secondary effects of the surgery, such as weight loss. 

One notable observation is that bariatric surgery can alter the gut microbiome, which may also help in the management of Type 2 diabetes.

Further research will be needed to understand how the gut microbiome may contribute to reversal of Type 2 diabetes in this context⁹. 

However, there are drawbacks to bariatric surgery that are worth considering. 

For instance, these surgeries can be quite expensive and come with the risk of complications during and after surgery. 

Additionally, the long-term effect of these procedures on the reversal of Type 2 diabetes is still under investigation, with most evidence suggesting that some—but not all—patients experience long-term reversal⁹. 

Can a low-carb (or low-calorie) diet reverse Type 2 diabetes?

Evidence suggests that low-calorie and low-carbohydrate diets can—in some people—lead to short term reversal of Type 2 diabetes⁹.  

The DiRECT study examined the effectiveness of such diets by restricting calorie intake to ~825-853 kcal per day for up to 5 months, followed by gradual reintroduction of certain foods.

Researchers in the DiRECT study found that 46% of participants with Type 2 diabetes managed to reduce their A1C levels below 6.5% and maintained it there for one year, and 36% of people with Type 2 diabetes maintained it for two years⁹. 

While the DiRECT study is promising, these intensive diets appear to be less effective at achieving long-term reversal. This is liekly due to difficulties with maintaining strict diets over a long period of time while also ensuring that you avoid nutritional deficiencies. 

Can exercise reverse Type 2 diabetes?

Exercise is an important part of managing Type 2 diabetes.

Exercise can help with weight loss and the immediate control of blood sugar.  

With both bariatric surgery and strict diets, exercise is an important supplement to help individuals stay in remission. 

Exercise alone, however, is unlikely to reverse Type 2 diabetes. 

Are there other methods to naturally reverse Type 2 diabetes naturally?

In addition to bariatric surgery and some strict diet changes, there are other, natural ways to achieve at least partial reversal of Type 2 diabetes, each of which focuses on reducing blood sugar levels in small ways.

Studies have shown that people with Type 2 diabetes may be able to lower their blood-sugar levels by increasing certain types of nutrients in their diets.

For example, fiber, American ginseng, and fenugreek have each been studied for their potentially beneficial effects on Type 2 diabetes¹². 

Fiber in particular is of interest because it’s known to help lower blood-sugar levels and to promote a diverse gut microbiome.

Cultivating a diverse gut microbiome is an emerging area of focus in diabetes management. Research suggests that the use of probiotic foods or medical probiotics—such as Pendulum’s Glucose Control—can encourage the development of a beneficial microbiome community which, in turn, helps those with Type 2 diabetes manage their blood-sugar levels. 

And while nurturing a diverse microbiome and getting exercise on their own cannot reverse Type 2 diabetes, it may help you move in the right direction.

Final Thoughts

Type 2 diabetes is a chronic condition, meaning people with Type 2 diabetes will likely have to contend with it for the rest of their life. 

But that doesn’t mean it can’t be managed to the point where they are effectively cured—having normal blood-sugar levels without needing medication. 

With the right guidance, the reversal can be achieved for some.

Additional Questions

Can Type 2 diabetes be reversed permanently?

At the moment, it does not seem as though Type 2 diabetes can be permanently reversed.

It is possible to reverse Type 2 diabetes and to sustain that reversal for the rest of a person’s life. Such a reversal would require continual effort to prevent the resurgence of diabetes symptoms. In this situation, the reversal is not permanent because Type 2 diabetes can return⁹.  

Can Type 2 diabetes be reversed without medication?

Yes, Type 2 diabetes can be reversed without medication in some people. Methods like bariatric surgery and intensive lifestyle changes, including diet changes, can lead to reversal⁹. 

Can Type 2 diabetes nerve damage be reversed?

According to the American Diabetes Association, Type 2 diabetes-induced nerve damage cannot be undone.

Fortunately, there may be ways to limit the amount of pain felt and to maintain functionality, depending on the severity of nerve damage¹⁰. 

Can fasting cure Type 2 diabetes?

No, fasting cannot cure Type 2 diabetes.

For the reasons described above, there is no way to truly cure Type 2 diabetes.

Fasting may lead to a temporary reversal of diabetes, however, once fasting is stopped blood-sugar levels will likely rebound unless followed by intensive lifestyle changes.

Attempts to treat Type 2 diabetes with fasting should first be discussed with your healthcare provider. 

How long does it take to reverse Type 2 diabetes?

Reversal of Type 2 diabetes can rapidly happen following bariatric surgery (within days of the surgery). However, when it comes to reversing Type 2 diabetes, the focus should be on the duration of reversal.

It is possible to very quickly lower blood-sugar levels, but maintaining normalized blood-sugar levels is the real challenge and the goal of reversing Type 2 diabetes⁹. 

1. “Type 2 Diabetes.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 30 May 2019, www.cdc.gov/diabetes/basics/type2.html.
2. Meyts, Pierre De. “The Insulin Receptor and Its Signal Transduction Network.” Endotext [Internet]., U.S. National Library of Medicine, 27 Apr. 2016, www.ncbi.nlm.nih.gov/books/NBK378978/.
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8. Buse, John B et al. “How do we define cure of diabetes?.” Diabetes care vol. 32,11 (2009): 2133-5. doi:10.2337/dc09-9036 https://care.diabetesjournals.org/content/32/11/2133
9. Hallberg, Sarah J et al. “Reversing Type 2 Diabetes: A Narrative Review of the Evidence.” Nutrients vol. 11,4 766. 1 Apr. 2019, doi:10.3390/nu11040766 https://pubmed.ncbi.nlm.nih.gov/30939855/
10. “Peripheral Neuropathy.” Peripheral Neuropathy | ADA, www.diabetes.org/diabetes/complications/neuropathy/peripheral-neuropathy.
11. Al-Mrabeh, Ahmad, et al. “Hepatic Lipoprotein Export and Remission of Human Type 2 Diabetes after Weight Loss.” Cell Metabolism, vol. 31, no. 2, 2020, doi:10.1016/j.cmet.2019.11.018. https://www.sciencedirect.com/science/article/abs/pii/S155041311930662X
12. McKennon, Skye A. “Non-Pharmaceutical Intervention Options For Type 2 Diabetes: Diets And Dietary Supplements (Botanicals, Antioxidants, and Minerals).” Endotext [Internet]., U.S. National Library of Medicine, 18 June 2018, www.ncbi.nlm.nih.gov/books/NBK279062/.