Can You “Reverse” Type 2 Diabetes?

^{Prof Winne Chee (in the photo above) is the moderator of the webinar.}

With the right diet and lifestyle management, diabetes remission is possible says experts.

Type 2 diabetes is often described as a progressive disease. If left unchecked, without the right healthcare intervention and lifestyle changes, it can gradually deteriorate over time and more medications will be required to manage the disease. But what about the opposite? With the right lifestyle changes and a resolute mind to be better at looking after one’s health, can you “reverse” the disease or more accurately, put it into remission? Reversal implies a permanent cure and unfortunately for Type 2 diabetes, there is no known cure. However, it is proven that the disease can be controlled and in some successful cases, it can go into remission. What remission means in Type 2 diabetes is that your blood sugar levels are healthy once more without the need to take any medication to control it. More specifically, your A1C (your estimated average blood sugar level or glucose level) has been reduced to the level of someone without diabetes (less than 6.5%) and therefore you are able to either limit the medication you are taking or eliminate it altogether for over six months or longer. Knowing this can mean hope for a lot of Type 2 diabetes patients but what exactly needs to be done? This was the focus of a webinar co-organised by the Center of Transformative Nutrition & Health (CTNH) at International Medical University (IMU) with the Malaysian Endocrine and Metabolic Society (MEMS), and the Malaysian Dietitians’ Association (MDA), titled “Diabetes in Malaysia and Southeast Asia: Is Remission Possible?”. Moderated by Prof Winnie Chee, Professor of Nutrition & Dietetics at IMU, the webinar featured notable speakers with valuable experience and knowledge in the disease such as Datuk Dr Zanariah Hussein, Head of Endocrinology Services from the Ministry of Health, Malaysia, and immediate past president of MEMS; Dr Anthony Leeds from University of Copenhagen and adjunct faculty at IMU who also practices bariatric medicine in the UK’s NHS in Diabetes and Endocrinology Department at the Central Middlesex Hospital in London; Prof Dr Susan Jebb, Professor of Diet and Population Health, and Prof Dr Paul Aveyard, Professor of Behavioural Medicine, both from University of Oxford. It was attended by over 550 participants who were physicians, dietitians, diabetes educators, nurses and other healthcare professionals from Malaysia, Singapore, Middle East and the UK.

However, with the right management for your diet and lifestyle, the risk of the disease is significantly reduced. For those living with diabetes, being on top of both factors can improve your quality of life. Says Datuk Dr Zanariah, “Lifestyle modification is the primary step once diabetes is diagnosed.” She cites the latest version of Management of Type 2 Diabetes Mellitus that recommends patients with Type 2 diabetes with aims of achieving diabetes remission to consider meal replacement therapy (MRT) and very low-calorie diet (VLCD). But how exactly does losing weight encourage diabetes remission? First, you need to understand what extra weight does to your body. Fat can build up around important organs like the liver and pancreas, making it difficult for these organs to work. This can lead to how Type 2 diabetes develops, though other factors come into play as well such as age, ethnicity, and family history. And the vice versa is true as well: Losing fat affects diabetes remission.

Further encouraging weight loss as a way to remission, Prof Susan Jebb says, “Even people who lose up to only 5kg, a small proportion of them will be successful.” Together with Prof Paul Aveyard, Prof Jebb has been studying the impact of weight loss in a primary care setting for Type 2 diabetes patients. “The point I want to make is that there is a linear relationship between weight loss and the likelihood of achieving remission.”

Whether it is the accelerated approach to weight loss or a gradual approach, the idea is simply to get started and find one that works for you. In fact, diet is not the only way for Type 2 diabetes remission; some patients have had bariatric or weight-loss surgery. It is important to speak to your healthcare provider for help because support plays an important role too, from the person helping you manage your diabetes to your loved ones.