Diabetes is so common that, as of January 2022, 11.3% of Americans have it. And 38% of Americans have prediabetes. While these statistics from the Centers for Disease Control and Prevention sound grim, being diagnosed with prediabetes or type 2 diabetes doesn't mean you're stuck with it.
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What you can do depends on the type of diabetes you have, but if it's prediabetes or type 2 diabetes, lifestyle changes can help. "Numerous studies show that with lifestyle changes, you can significantly reduce your blood sugar levels," says Vanita Rahman, M.D., clinic director of the Barnard Medical Center in Washington, D.C., internal medicine physician, certified nutritionist and author of Simply Plant Based. "We have many anecdotal reports of people completely reversing type 2 diabetes."
So how do they do it? As you might have guessed, lifestyle changes are at the crux of the reversal strategies.
Diabetes occurs when your blood sugar, called glucose, is too high. One test doctors commonly use to diagnose as well as manage diabetes is A1C, a blood test that, in simplest terms, measures the sugar in your blood. Technically, it measures the percentage of your red blood cells that have what the CDC calls "sugar-coated hemoglobin." Hemoglobin is a protein that sugar attaches to as soon as it enters your bloodstream.
A normal A1C is anything below 5.7%. If your blood sugar is between 5.7 and 6.4%, that's prediabetes. If you have diabetes, your A1C will be 6.5% or higher.
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So what does it mean to reverse diabetes? As you might suspect, "When your A1C has dropped to a normal level," Rahman says.
Yet this comes with a caveat, as not everybody who has diabetes can reverse it. For starters, while there are two main types of diabetes, only people with type 2 diabetes have a chance of reversing it. That doesn't mean people with type 1 diabetes, characterized by their body not being able to produce insulin, can't work to lower their blood sugar, but they will always need some insulin to live, Rahman says. There may also be some individuals whose type 2 diabetes is too advanced to reverse.
Not surprisingly, the same lifestyle strategies that can help lower your blood sugar are the ones that can help reduce your risk of heart disease and other conditions. But there's real-life proof that they work against diabetes.
Take, for instance, a man in his 50s diagnosed with diabetes with an A1C of 7.0%. He began working with Beth Olmstead, B.S.N., RN, a health coach and owner of Honeybee Health Coach in Warsaw, North Carolina, and over the next three months, the lifestyle changes he made resulted in an A1C drop to 5.0%. During that time frame, he also lost 22 pounds.
Now consider one of Rahman's patients who had an A1C close to 12% when they started working together. The woman's previous physician had prescribed insulin, which she didn't want, so because she'd heard about the benefits of plant-based eating, she sought Rahman's help. Six months after transitioning to a plant-based diet, her A1C had dropped to 5.16%. She also lost weight, lowered her cholesterol and went from being unable to walk past her yard to walking a few miles a day.
So what should you do if you want to lower your blood sugar, too? Follow these four strategies.
Numerous studies show that eliminating animal foods and eating a low-fat, plant-based diet can significantly reduce blood sugar levels. In fact, a 2021 study in Advances in Nutrition found that plant-based diets are helpful for the prevention and treatment of diabetes. Why? Two reasons. For starters, "Whether it's dairy, poultry, red meat or fish, animal foods are high[er] in fat, and it's dietary fat that significantly impacts how well insulin works," Rahman says. Insulin is responsible for letting your body's cells absorb glucose from your blood, but when you're eating a high-fat diet, even just for one meal, the fat limits insulin from doing its job.
The second reason is fiber, which helps control blood sugar, among other things. Animal foods contain no fiber, and because most Americans eat such a high amount of animal foods, they're lacking the fiber they need. According to the Dietary Guidelines for Americans 2020-2025, more than 90% of U.S. adults don't consume enough fiber. Dietary guidelines suggest that, depending on age, adult females need 22 to 28 grams of fiber, and males 28 to 34 grams a day.
Excess weight not only raises your risk for type 2 diabetes, it can also increase your blood sugar. Yet by managing your weight, you'll improve your insulin sensitivity and lower your blood sugar. The good news? If you're switching to a low-fat, plant-based diet, you'll probably manage your weight easier. "The more plants you eat, the more you'll lower the caloric density (the number of calories in a given volume of food) of your food, which will help you lose weight," Rahman says. Plus, the fiber in plant foods will make you feel more full.
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The Physical Activity Guidelines for Americans recommend that individuals do at least either:
They also recommend doing strength exercises at least two days a week. For some people, that might be either intimidating or just too much, which is why Olmstead recommends starting small and breaking it into smaller chunks. "It doesn't have to be all at once and you can even start with just five minutes of walking," she says. For instance, take five-minute brisk walks for an hour or do a 15-minute walk in the morning and another after work.
If sleep has fallen to the last item on your to-do list, it's time to reshuffle your priorities. "Although we don't know exactly why we need sleep, we know you can't survive without it, as it rejuvenates your body and brain," Rahman says. Studies, in fact, point to lack of sleep being a contributor to health issues like heart disease, obesity and diabetes. And on a practical level, if you're not getting the sleep you need, you probably won't have the energy to exercise, you may not think clearly and you may be more tempted to reach for quick food fixes like sugary treats to feel energized, she adds. Although the CDC recommends logging more than seven of sleep a night, everybody's sleep needs can be different. "Base your needs on how refreshed you feel the next morning," she says.
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While you can certainly do these things on your own, it's wise to check with your health care provider first. "Ask your physician if there are any barriers to modifying your diet or starting or increasing an exercise program," Olmstead says.
Of course, it's one thing to start implementing these strategies, but once you lower your A1C, you've got to keep them up. "Just like any lifestyle modification for weight loss or dietary changes for high cholesterol, if you revert back to old habits or get too lenient on food choices, those numbers can creep back up to concerning levels," Olmstead says.
