Diabetes is a chronic condition, but that doesn’t necessarily mean you’ll always be managing high blood sugar. Depending on the type of diabetes you live with (namely, type 2), remission can be possible for some. So, how long does it take for type 2 diabetes remission—and what exactly does it take to get there?
When Is Remission Possible In Diabetes?
To recap, there are multiple types of diabetes, the most common being types 1 and 2.
“Type 1 diabetes is an autoimmune condition,” explains One Drop coach, Alexa Stelzer, a registered dietitian/nutritionist (RDN) and certified diabetes care and education specialist (CDCES). “Your body’s immune cells make cytokines (a protein that causes inflammation) that trigger a series of reactions that lead to the death of beta cells in the pancreas.” Beta cells make insulin (a hormone that regulates your blood sugar), and without them, your body struggles to use sugar for energy.
“The death of beta cells in type 1 diabetes is thought to be irreversible,” notes Stelzer. But in type 2 diabetes, she says, “long-term high blood sugar and free fatty acids can cause beta-cell dysfunction,” which may eventually lead to cell death, “but there is a period of time when the dysfunction may be reversible.”
How Do You Achieve Type 2 Diabetes Remission?
The guidelines state that those living with type 2 diabetes can be considered in remission after demonstrating normal blood sugar levels (defined as A1C level of less than 6.5%) for three months or more without taking glucose-lowering medication.
In other words, remission becomes possible when you find ways to maintain healthy blood sugar levels long-term without having to rely on medication to achieve those results.
To be clear, though, that doesn’t mean there’s anything wrong with or shameful about taking medication for diabetes. “It helps to see healthcare as self-care,” no matter what that looks like for you, says One Drop coach, Rukiyyah Khan, a certified diabetes prevention specialist who lives with type 1 diabetes and specializes in plant-based nutrition. “Whether you’re taking medication, taking care of your mental health, or practicing other healthy habits, these are all ways to show ourselves love and preserve our well-being.”
Aside from medication, many strategies can be used to achieve remission in type 2 diabetes. In terms of nutrition, research shows that about half of people with type 2 diabetes who are within the first 10 years of diagnosis and maintain a generally low-calorie, low-carb way of eating can achieve remission.
Low-carb and low-calorie eating methods not only help to keep blood sugar levels in a healthy range, but they can also help with weight management—one of the most important factors in achieving type 2 diabetes remission, according to William Cefalu, MD, director of the Division of Diabetes, Endocrinology, and Metabolic Diseases at the National Institute of Diabetes and Digestive Kidney Diseases (NIDDK).
In a recent Q&A for NIDDK, Dr. Cefalu highlighted the results of the Diabetes Remission Clinical Trial (DiRECT), a study designed to assess whether a structured weight management program in a primary care setting can help people living with type 2 diabetes achieve remission.
“DiRECT found high rates of type 2 diabetes remission among people who lost a significant amount of weight—more than 10 kg (about 22 pounds)—and sustained the weight loss over 12 to 24 months,” explained Dr. Cefalu. (Learn more about the benefits of weight management and how to approach it with a healthy mindset.)
For what it’s worth, though, researchers have also noted that “the best diet for longer term success” in type 2 diabetes remission “will be one which is easiest for an individual to adhere to in the long term.” In other words, while focusing on macros and calories can certainly get you closer to your health goals, that’s not the only approach that can work. It also helps to consider the overall quality and types of food you’re eating; emerging research shows that increasing your intake of whole, fresh foods and reducing your intake of ultra-processed foods may provide significant benefits in terms of both blood sugar and weight management.
How Long Does It Take for Type 2 Diabetes Remission?
The short answer: It depends.
While the current research suggests type 2 diabetes remission is possible for many people, it’s also important to note the progressive nature of the condition, says One Drop coach, Julia Dugas, RDN, CDCES, and certified personal trainer (CPT). Meaning, even though remission is possible, it’s also possible that you may eventually need to take medication again to manage your blood sugar.
“Typically, as time goes on, more beta cells in the pancreas will die, meaning less insulin will be produced, and your body will need more help to manage those conditions,” potentially with oral medication or insulin, explains Dugas.
The truth is that “we simply can’t say how long it takes for type 2 diabetes remission,” continues Dugas, nor can we say how long it will last once you do achieve remission. “It’s not possible for everyone, but it’s also not necessarily a goal for everyone either. There’s no shame in using medications or insulin to manage your health; it doesn’t mean you’ve failed. It simply means you’ve found a way to stay healthier, longer that works for you.”
Ultimately, it’s about finding your “why” for achieving remission, says Stelzer. Ask yourself: Do you feel a stigma associated with diabetes? Do you want to reduce your risk of complications? Do you want to stop taking medication?
“Understanding why you may be pursuing remission can help us create personalized goals that address your concerns,” explains Stelzer. “We can set goals that contribute to factors like healthy eating, exercise, and positive self-talk. Even if these goals don’t result in remission, they’ll certainly benefit your blood sugar levels and overall health.”
This article has been clinically reviewed by Alexa Stelzer, RDN, CDCES, and clinical health coach at One Drop.