Can Diet and Exercise Put Diabetes in Remission?

Look online or on social media and you’ll find countless stories of people who claim they “reversed” diabetes by eating a certain food or trying a quick fix that let them stop taking medication. But is diabetes reversible or are these stories too good to be true?

The answer is more nuanced. For starters, the phrase “diabetes reversal” suggests you can stop having the condition, says obesity specialist and endocrinologist Dr Leon I. Igel. “‘Diabetes reversal’ does not consider the chronic and often progressive nature of diabetes,” he says. The word "reversal" implies you can return to life before diagnosis, which isn’t the case. You’ll need to maintain any lifestyle changes that helped improve your numbers.

So if reversal isn’t quite right, what is? Clinical guidelines consider some types of diabetes to be in “remission” when a person maintains normal blood glucose levels for at least three months without taking diabetes medication.

So will a diabetes diagnosis stick for life or can you bring it into remission? Below, endocrinologists explain which kinds of diabetes can enter remission, plus practical steps to reach remission or manage your condition effectively.

Can prediabetes go into remission?

Yes—often.

People with prediabetes tend to have impaired insulin release and insulin resistance, explains endocrinologist Dr Priya Jaisinghani. These changes push blood glucose higher and can progress to type 2 diabetes, so remission means improving both.

How to achieve remission:

Choosing a nutritious eating pattern and moving more can lead to weight loss, which helps reduce insulin resistance. People living with obesity often have higher levels of inflammation that contribute to insulin resistance and “these lifestyle changes may decrease certain inflammatory markers,” says Dr Jaisinghani.

In some cases a clinician may prescribe metformin, a medicine that lowers blood glucose by reducing glucose production and improving insulin sensitivity. While taking medication means you’re not technically “in remission,” it can be a useful way to stop prediabetes progressing to type 2. If medication helps stabilise your numbers while you lose weight, you may later be able to stop it and meet the definition of remission.

Can type 1 diabetes go into remission?

Unfortunately, no.

Type 1 diabetes is an autoimmune condition. While a few people experience short-term remission after a pancreas transplant, the vast majority won’t. In type 1, the immune system destroys the insulin-producing cells of the pancreas. Because the root cause is the body’s inability to make insulin, says Dr Igel, treatment focuses on lifelong management rather than “getting rid of it.”

How to manage it:

Dr Igel recommends working with an endocrinologist to learn carbohydrate counting, check blood glucose, prescribe and administer insulin and recognise and treat hypoglycaemia. With support and good information, you can live a long healthy life with type 1 diabetes.

Although there’s no cure, Dr Jaisinghani notes there is hope in emerging therapies. There is a recently approved cell therapy uses donor islet cells to restore some insulin production in people with type 1 diabetes who frequently have severe hypoglycaemia. Some recipients can reduce or even stop injected insulin, although ongoing immunosuppression is required to keep the transplanted cells alive. In parallel, a separate stem-cell–derived islet therapy has shown promising early results and is moving into phase 3 clinical trials. More research will clarify who benefits most and how safe these options are long term.

Can type 2 diabetes go into remission?

Yes, sometimes.

Medicine, lifestyle changes and surgery can return glucose levels to normal or near-normal in some people with type 2 diabetes. If someone maintains those levels for three months after stopping medication, their diabetes is considered in remission, says Dr Jaisinghani. It isn’t always possible and it isn’t easy.

How to work towards remission:

Taking medicines such as metformin can improve blood glucose and some treatments also make weight loss easier, which helps reduce insulin resistance, says Dr Igel.

Another increasingly used option is the class of medicines called GLP-1 receptor agonists. These weekly injections stimulate insulin release when glucose is high and slow gastric emptying so you feel fuller sooner and for longer. That combination improves glucose control and can support weight loss.

Weight loss itself can lessen insulin resistance, says Dr Jaisinghani. For people living with obesity, bariatric surgery has been shown to improve insulin sensitivity and some insulin-producing cell function. As with prediabetes, a nutritious eating pattern and regular exercise support weight loss, which in turn can decrease insulin resistance.

Even if you don’t reach remission, the steps you take to manage type 2 diabetes can help you live longer and feel better day to day.