Can Diabetes go away with diet and exercise?

There is no cure yet for type 2 diabetes, but it may go away in some people, at least for a while. When type 2 diabetes goes away, it is called a remission.

• Diabetes remission may be defined as blood sugar levels returning to normal range for at least 3 months without any use of diabetes medication.
• The cause of type 2 diabetes remission is usually significant weight loss.
• Remission is not a cure because if weight comes back, so does diabetes and high blood sugar.

Weight loss that leads to remission can be achieved by restricting calories, exercising and/or weight loss surgery, called bariatric surgery. According to the National Institute of Diabetes and Digestive and Kidney Diseases, studies have shown that type 2 diabetes remission typically requires weight loss of at least 22 pounds that is maintained for 1 to 2 years.

Weight loss and diabetes

Diabetes researchers are still learning how remission occurs. Weight loss may increase the ability of the pancreas to make insulin. Insulin is the chemical messenger (hormone) that your body needs to use sugar for energy. People who have good pancreatic function before losing weight and who have had diabetes for shorter periods of time are most likely to achieve remission through weight loss.

Once a person is diagnosed with type 2 diabetes, the pancreas may lose the ability to recover over time, so it is important to try to achieve weight loss and remission early in the course of the disease. Type 2 diabetes is a disease that gets progressively worse over time. Even if losing weight does not lead to a complete remission, weight loss can also lead to:

• Better control of blood sugar
• Using less medication
• Lower risk of diabetes complications

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Testing for diagnosis and remission

About 10% of people in the U.S. are diagnosed with diabetes, and that number has been increasing. Health care providers usually use two tests to diagnose type 2 diabetes:

• One is a blood sugar test after fasting, called fasting plasma glucose. Diabetes can be diagnosed if this number is 126 or higher.
• The other test is the A1C test, which is the average percentage level of blood sugar over three months. Type 2 diabetes can be diagnosed if this number is 6.5 or higher.

These tests may be repeated or confirmed with another blood glucose test to make a diagnosis.

To diagnose a type 2 diabetes remission, your health care provider may want to see one of the following:

• An A1C test value less than 6.5 without using any diabetes medications
• A fasting plasma glucose level less than 126 seen periodically for at least 3 months without using any diabetes medicines when A1C is not a reliable indicator
• An estimated A1C less than 6.5 without using any diabetes medicines from continuous glucose monitoring

Testing to confirm remission is recommended at least yearly, but may be more frequent in some people.

Type 2 diabetes remission is more common than diabetes experts once thought. Researchers are still learning how often remission occurs, how long it lasts and how it affects the course of type 2 diabetes over a lifetime.