Ok, tell me if you’ve heard any of these:
The keto diet REVERSES diabetes
Going vegan REVERSES diabetes
Weight loss REVERSES diabetes
Intermittent fasting REVERSES diabetes
(Replace reverse with cure, you’ve got the same idea.)
Is any of this true? Is there one diet that is better for diabetes than another diet?
The truth is, there is no magic diet for reversing diabetes because….
wait for it...
...you can’t REVERSE diabetes.
There. I said it. Diabetes is an irreversible process. I know that’s scary because it is so normal to want to measure up to this one ideal of a specific weight, a specific A1C, and blood sugars that are in range.
What can get tricky here is that we use measurements (A1C and blood glucose) to diagnose diabetes. The American Diabetes Association lists cut-offs for diagnosis as:
an A1C of 6.5% or higher,
fasting blood glucose of 126mg/dL or higher,
or a 2 hour post glucose test of 200mg/dL or higher¹.
So, one might think that if all of these numbers are brought back to a “non-diabetes” level, then they no longer have diabetes. Right? The feeling is: “If I do everything perfectly then I can be healthy and reverse my diabetes.”
It is possible to lower blood sugar and A1C with adequate support, medication if appropriate, movement, self care, and/or diet changes. But what happens when those things are removed or discontinued? Diabetes “comes back.”
This means that a reduction in A1C and blood glucose is not a sign of reversal but a sign of WELL CARED FOR diabetes.
Putting this unrealistic expectation on yourself or people you know with diabetes is problematic and harmful. It assumes that:
If someone is not able to lower their blood sugar and A1C to non-diabetes levels, they aren’t taking care of themselves or they are lazy.
If you work hard enough, you can reverse diabetes.
You cannot be healthy if you have diabetes.
You cannot live a long, full, and meaningful life with diabetes.
People with diabetes are unhealthy.
What a lot of PRESSURE.
Trying to get blood sugars that are near perfect is unreasonable. The goal is not to be “fixed” - the goal is to take care of yourself.
If you want a little bit of evidence for this- “normal” A1C is under 5.7% (in other countries, it’s considered under 6.0%3), but we don’t see an association between diabetes complications and A1C until over 7%. Even then, there is a VERY small increase in risk until much higher A1Cs². (Don’t fret if you do have a high A1C, though! It’s never too late to start working on taking care of yourself in sustainable ways.)
So the moral of the story:
No, you cannot reverse diabetes. But that absolutely positively does not mean that you can’t be a healthy, happy human living well with your diagnosis.
Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020; Diabetes Care. 2020;43(Supplement 1):S14 LP-S31. doi:10.2337/dc20-S002
Skyler JS. DIABETIC COMPLICATIONS: The Importance of Glucose Control. Endocrinol Metab Clin North Am. 1996;25(2):243-254. doi:https://doi.org/10.1016/S0889-8529(05)70323-6