For Your Health: Reversing type 2 diabetes


It is the time of the year again to set New Year’s resolutions. These often include losing weight, eating healthy and exercising.

If you are an individual with type 2 diabetes, improving blood glucose levels may be one of your resolutions.

First and foremost, talk with your health care provider, licensed dietitian or certified diabetes educator to make sure that any diet or exercise regimen is safe for your medical conditions. The internet can be a good resource, but it is important to remember that quality information comes from peer-reviewed scientific journals rather than opinion columns.

Yes, reversing type 2 diabetes is possible and may be defined as being able to stop all medications and keeping glucose levels in a normal range. Recent published studies confirm what we have observed here in practice: people with type 2 diabetics enrolled in a medically supervised weight loss protocol can reverse diabetes and decrease the need for medications. It has been shown that the pancreas and liver – two organs central to blood glucose control – improve in function after weight loss.

Other studies show that weight loss via a medically supervised very-low-calorie regimen have similar results as bariatric surgery, but without the risk of surgery. Not only do patients see improvement in type 2 diabetes, but other conditions such as high cholesterol, high blood pressure and sleep apnea as well.

Fortunately, an individual may also save money with discontinuation of oral medications and perhaps insulin. Weight loss may lower the risk of heart and kidney problems along with a reduced risk of early death.

So, what should you eat?

Scientists at the NIH have convincingly shown that weight loss is achieved by a reduction in calorie intake, whether a low fat or a reduced carbohydrate diet. It is adherence to caloric reduction and consistency of the selected dietary pattern that is most important, rather than percentages of macronutrients in fats or carbohydrates.

These studies also show that with long-term commitment to behavior changes, risk of weight regain exist. Discuss healthy eating habits with a licensed medical professional and consider a target number of calories per day that would enable weight loss. You also may visit The Body Weight Planner at http://niddk.nih.gov/bwp to get an estimate of caloric intake for weight loss.

Also, discuss with your provider any vitamin or mineral supplements, as most of the time these are not necessary with a balanced dietary pattern. Finally, even with weight loss of 3 percent to 5 percent of body weight, glucose and cholesterol levels may improve, and often quality of life improves.

The American Diabetes Association suggests eating a wide variety of non-starchy vegetables, at least half your plate for lunch and dinner, plus a quarter plate size portion of lean protein and whole grains or beans. It is recommended to minimize sodium intake and try to obtain as few calories as possible from beverages. Snacks are often not necessary, but could include berries, light cheese or yogurt or a small portion of almonds.

Another goal is to consider higher-fiber intake: aim for 25-30 grams of fiber daily from whole foods. Try to minimize ultra-processed foods and reduce portion size.

Any food may be enjoyed in moderation, but all calories count.

Unfortunately, exercise alone has not been shown to consistently cause weight loss, however it is essential for heart and mental health, reducing blood glucose levels and weight loss maintenance. If your health care provider agrees, then you could exercise at home or the gym, inside or outside, aiming for 150 minutes per week of moderate intensity exercise such as walking. These minutes may be divided into 30 minutes, five days a week or even smaller, more frequent intervals.

Adding muscle strengthening exercise is also beneficial to avoid muscle loss associated with aging. For people with diabetes who experience high blood sugar levels after a meal, exercise afterward can help lower glucose spikes.

Let us turn the calendar to 2021 — hopefully a better year — and keep these important resolutions to put diabetes into remission.

Dr. Christopher Case is an endocrinologist with Jefferson City Medical Group who cares for patients with diabetes, obesity, osteoporosis, cholesterol disorders, and diseases of the thyroid and adrenal and pituitary glands. He is a Jefferson City native and graduate of Helias High School who enjoys exercise, major league baseball and the Missouri Tigers.

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