Dear Dr. Roach: Any suggestions on how to reverse Type 2 diabetes? — C.B.
Answer: Strictly speaking, once you have diabetes, you always have diabetes, as the diagnosis is considered “stable,” or lifelong. However, many people can get diabetes under control without medications so that the blood sugar is always in the normal range, which is pretty close to reversing diabetes.
The three most important areas of controlling diabetes are diet, exercise and weight. While there is much information I can give on diet, the most important single factor is reducing sugar and starches (which rapidly turn into sugar). It’s not all carbohydrates that are bad — vegetables and legumes, which are mostly carbohydrates, have very little starch and sugar and high amounts of fiber, forming one of the bases of a healthy diet for diabetes, along with healthy protein sources. A registered dietician or nutritionist is an essential partner in diabetes care. Entirely (or nearly) cutting out breads, pastas and rice makes an enormous difference in blood sugar.
The body makes its own sugar, and regular exercise not only uses up blood sugar, but it also trains the muscles to use sugar more efficiently. Exercise alone will not reverse diabetes in people who have a poor diet, but the combination of a good diet and regular exercise is better than either alone.
Weight has an independent effect on blood sugar control, as a higher weight usually correlates to more resistance to insulin.
However, a person can have Type 2 diabetes and be very thin, and most people who are overweight do not have diabetes. For most people, a diabetic-friendly diet and regular exercise will end up leading to weight loss, but it will always lead to improved health, even without losing a pound.
