Is type 2 diabetes reversible?

how do you reverse type 2 diabetes can everyone do it or does it only work for some people so the whole question of the reversal of diabetes is such an interesting one because most people who have been through medical school been through nursing school been through dietetic school learned that diabetes is not a reversible disease and it’s probably only been in the last maybe 15 years that that’s been on our radar maybe 20 i think james anderson’s work in in the 70s and 80s gave us some hints that it was a reversible disease but but certainly many health professionals still believe that that it’s a progressive irreversible disease but what there are a couple of things they need to know number one is in 2009 the american diabetes association released a paper defining diabetes reversal and they defined it as number one people would be on no medications number two they would have normal glycemic measures normal a1cs normal fasting glucose and number three they would re maintain this for at least a year now that’s the part that’s controversial the controversial at least a year some folks will say if the three months is enough six months is enough but what we know is they need to be off medications and have normal glycemic measures and if they have that they if they don’t have a fasting blood sugar of 126 milligrams per deciliter they’re not diabetic if they don’t have you know a1cs in the diabetic range they’re not diabetic and yes it’s true they could become diabetic again quite easily if they revert to their old ways and regain the weight and so forth but diabetes is a reversible disease i have seen many people reverse this disease and and so how do we reverse it well number one we need to understand diabetes type 2 diabetes is a disease of insulin resistance so in most people the pancreas is still functioning which is not true in type 1 diabetes where the beta cells have been mainly destroyed or completely destroyed and and in type 2 diabetes the beta cells are often still functioning now they can become less well functioning and we can lose some over time because of this you know constant overuse and trying to put out so much insulin to compensate for high blood sugars that the pancreas can literally conk out eventually but for most people there is function in that pancreas so what we need to do is we need to reverse insulin resistance so what causes insulin resistance well insulin resistance i think is a function of of several things so one of which is overweight and obesity overweight and obesity cause inflammation because you get this production of adipocytes or cytokines that are these inflammatory compounds especially from your visceral fat stores that that that contribute to insulin resistance you get oxidative stress which you know again contributes to inflammation and insulin resistance and then the other two really key players are dysbiosis dysbiosis in of itself is an unhealthy gut flora and and you can get production of these inflammatory compounds that leak into the bloodstream your your gut becomes leaky and these things get into the bloodstream and again can can contribute to insulin resistance and endotoxemia and all of these things and then the biggie which many people are completely unaware of is called lipotoxicity and this is the kingpin so lipotoxicity is a situation where you begin to store fat in places where it should not be so fat we have this unlimited ability to store fat and and it is normally stored in our adipose tissue and adipose tissue can just keep storing and storing and storing and storing however when excess calories are coming in at such a high rate that the body can’t shuttle it off to the fat stores fast enough it sometimes ends up worming it its way into places it shouldn’t be your liver your pancreas your heart tissue and your muscle tissue and that is lipotoxicity when you store fat in your pancreas it kills your beta cells when you store fat in your liver it makes your body highly insulin resistant when you store fat in your muscle tissue and of course we all store some fat in our muscle tissue in something called intra myocellular lipids and and and if you’re an athlete you actually even have more of these because you need that fast burning fuel to be readily available to your muscles but in people who are overweight and diabetic they get so much fat shoved into their muscle tissue that their muscle tissue becomes very insulin resistant and so the intramyocellular lipids can actually block insulin signaling and this is a huge issue and so what we see is is that as people begin to lose weight get start eating more healthfully and their body fat comes down the lipotoxicity starts to decline and in fact one of the first clues we had that insulin resistance could be you know could be reversed was in people undergoing bariatric surgery so they would undergo bariatric surgery and the weight loss would happen very very rapidly and within a week or two their insulin resistance was gone because one of the first places that they would burn the fat off was from their liver and once you get liver fat down you restore insulin sensitivity so that was clue number one and then these groups started to say well i wonder if we could get the same thing if we just put people on a really strict like super low calorie six to 800 calorie diet giving them these liquid beverages and that’s it and sure enough lipotoxicity came down and insulin resistance went away and and then the third sort of level of evidence we now have is people consuming these whole food plant-based diets and it’s a more gradual reduction of of lipotoxicity but we see it dr joel furman did a study it was a very small study of you know but but these individuals in his study i i believe it was 62 percent or or or thereabouts completely went off medications and reversed their disease and we it was you know we have a group that’s working um on a a diabetes program on online it’s called the e4 live diabetes solutions they’re seeing numbers about the same in the 60 some percent of their folks who are really adherent are seeing complete reversal of the disease and so this is this is exciting news and so we know that by following a diet that doesn’t include a lot of processed foods or animal products that we can see tremendous improvements and restore our insulin sensitivity