There are several strategies to prevent type 2 diabetes, but reversing the condition after you have it isn’t as clear. Type 2 diabetes is the most common type of diabetes, and it usually develops in adulthood. Type 2 diabetes is never really cured, but it’s possible to get diabetes under control and enter a state of remission — when blood sugar levels are in a normal range for at least three months without taking diabetes medication.

For people with type 2 diabetes, problems with insulin lead to elevated blood sugar levels. Insulin is a hormone made by the pancreas that regulates how the body uses sugar. Usually, type 2 diabetes is caused by insulin resistance, meaning insulin stops working effectively. Without intervention, insulin resistance is progressive and can gradually transform prediabetes into a type 2 diabetes diagnosis.

Here are some common questions and answers about reversing type 2 diabetes.

1. Can a Diet Reverse Type 2 Diabetes?

Healthy eating is essential for diabetes management, but it can’t necessarily reverse the disease. It may help you bring your type 2 diabetes closer to remission and avoid diabetes-related health complications.

If you and your doctor have identified weight loss as one of your diabetes-management strategies, a nutritious, low-calorie diet can improve insulin sensitivity and may reduce your need for diabetes medications. In addition, limiting carbohydrates can be highly effective in lowering hemoglobin A1c levels. Studies have shown that both low-calorie diets and low-carb diets have benefits for type 2 diabetes remission lasting up to two years.

Studies also show that plant-based or vegan diets can be beneficial for managing type 2 diabetes and avoiding complications related to heart disease or kidney disease.

There’s a growing interest in ketogenic diets for diabetes. A ketogenic diet is a low-carb, moderate-protein, and high-fat diet. In one study, researchers compared a group of people with type 2 diabetes on a very-low-carbohydrate ketogenic diet with others following the American Diabetes Association’s Diabetes Plate Method (a low-fat meal plan emphasizing nonstarchy vegetables). A1c levels, body weight, and triglyceride levels decreased more significantly for the ketogenic diet group.

A second study at Stanford Medicine had people with type 2 diabetes try either the ketogenic diet or the Mediterranean diet (which emphasizes fresh vegetables, whole grains, and lean meats). That study found that both the keto and Mediterranean diets improved A1c levels, promoted weight loss, and helped regulate diabetes. But the participants reported that the Mediterranean diet was much easier to stick with over time.

With so many potential meal plans, it can be hard to know what to focus on. The most important dietary guidelines for people with type 2 diabetes, the Stanford researchers stressed, are to avoid added sugar and refined grains and eat more vegetables. To that end, learning to make healthy food substitutions in the meals you currently eat might be a good start.

It’s crucial to talk to your doctor before making sudden dietary changes, especially if you take insulin for diabetes. Reducing carbohydrates without adjusting your medication or monitoring your blood sugar could lead to dangerously low blood sugar. Enlist the help of your health care team (including a dietitian) to modify your diet with supervision.

2. Does Bariatric Surgery Cure Type 2 Diabetes?

Weight-loss surgery, also called bariatric surgery, is highly effective against diabetes in the short term for people with higher body weights. Research has shown that up to 80 percent of people experience significant blood sugar improvements within days of surgery, sometimes “reversing” diabetes before weight loss even starts.

However, long-term remission isn’t guaranteed. Type 2 diabetes can return over time. In addition, bariatric surgery comes with potential health risks and complications, as well as considerable cost for those without health insurance.

To determine if the benefits of bariatric surgery surpass the risks for you, your health care provider can assess your physical and mental health. They’ll also share what you should expect from life after surgery, so you understand how this change to your digestive system may affect your life.

3. Can Lifestyle Changes Get Rid of Type 2 Diabetes?

Research shows that weight loss can help with diabetes remission. One study in the UK showed that 64 percent of people who lost at least 22 pounds were in remission from type 2 diabetes after two years. However, losing 5 percent of your body weight, or even just 5 pounds, can help you manage diabetes symptoms and provide significant health benefits.

Weight loss is not always a healthy goal for everyone, and dieting can be complicated when you’re trying to balance blood sugar levels with medications such as insulin or sulfonylureas. If you and your doctor determine weight loss is appropriate for you, ask your health care providers for help in planning a diet that takes type 2 diabetes into account.

Raising your physical activity level also supports weight loss and increases the chance of at least partial diabetes remission. Joining a lifestyle-focused diabetes program may offer greater success than going it alone. One small study of people recently diagnosed with type 2 diabetes showed that a program of structured physical activity and weight loss counseling helped inspire partial diabetes remission. The plan also delivered a range of benefits that no single medication can achieve, including better insulin sensitivity, blood pressure, and aerobic capacity. Ask your doctor if your health care provider offers any programs for diabetes management.

It’s important to remember that diabetes is an inflammatory condition. Research suggests diabetes treatment could target inflammation to improve symptoms and reduce the risk of further health complications. Smoking, high stress levels, and insufficient sleep are all habits that increase inflammation and can worsen type 2 diabetes symptoms. As much as possible, make time for rest and relaxing activities. If you’d like support to quit smoking, ask your health care provider.

The Future of Diabetes Treatment

Researchers are studying several approaches to treating the inflammatory aspects of diabetes. These include anti-inflammatory diets, immunotherapy medication, and altering the gut microbiome. Whether any of these options will allow the reversal of type 2 diabetes remains to be seen.

Stem cell research also offers hope for a type 2 diabetes cure in the future. As stem cell research continues to develop, more sophisticated and targeted treatments are expected to usher in a new phase of treatment for chronic diseases. Several clinical trials around the world have explored the possibilities of stem cell therapy for both type 1 and type 2 diabetes, but more work must be done before treatments become available.

Talk With Others Who Understand

DiabetesTeam is the social network for people with diabetes and their loved ones. On DiabetesTeam, more than 127,000 members come together to ask questions, give advice, and share their stories with others who understand life with type 2 diabetes.

Have you experienced partial or full remission of type 2 diabetes? What lifestyle changes have you made to improve your blood glucose or A1c levels? Share your comments below, or start a conversation by posting on your Activities page.