It's Not Your Fault

Can Type 2 diabetes be reversed? This is a question a lot of my readers ask me. Their doctors may tell them that if they lost weight they'd reverse their diabetes and there are books on the market that claim the same thing.

Unfortunately, the concept of "reversing" diabetes doesn't hold up well to scrutiny.

The media version is that Type 2 Diabetes is caused by gluttony and sloth and can be prevented or cured by diet and exercise, but the truth is quite different. The research makes it very clear that overeating doesn't cause diabetes. You can read the documentation for this HERE.

This should help you stop blaming yourself for your condition if you have Type 2 diabetes, but it also implies that if you have the underlying condition, which manifests clear clinical indicators when people with diabetic heritages are young and thin, you aren't going to cure the underlying condition with simple interventions.

But what about the studies where interventions "prevent" diabetes? Well, a lot of them turn out to be studies where a group of people with marginal blood sugars--for example an average fasting blood sugar of 123 mg/dl (6.8 mmol/L)-- do something that keeps their blood sugar at 123 mg/dl compared to another group who start out the same but end up with a blood sugar of 126 mg/dl (7 mmol/L). Because diabetes is diagnosed with strict cutoffs, and the fasting cutoff for diagnosing diabetes is 125 mg/dl (7 mmol/L), the first group "prevents diabetes" and the second develop it. The actual difference between the two groups is minuscule and they both have the same likelihood of developing diabetic complications.

Weight loss can make blood sugar control easier, and there are studies of people who have pre-diabetic blood sugars that make it look like losing weight can "prevent diabetes." But it is worth remembering that the vast majority of the obese who have pre-diabetic blood sugars will never develop diabetes. So interventions where people with pre-diabetes lose weight and with it the insulin resistance caused by overweight may make it look like they "prevented diabetes" but the intervention may have only been effective in those people whose marginal blood sugars were caused by factors other than the genetic damage that leads to diabetes--people, in short, who would never have developed diabetes.