Is It Possible to Reverse Diabetes?

Can you reverse prediabetes with diet? Consider these strategies which can also help you lower blood pressure, improve cholesterol, and lower ...
Can You Reverse Prediabetes?
Natalie Stein

Exercise, Fitness & Nutrition Expert | Lark Health

Can you reverse diabetes? Yes, and it can be done without medications, according to research published in thejournal Lancet

Having prediabetes increases the risk for developing diabetes, so it is natural to wonder if you can reverse prediabetes. The great news is that in many cases, prediabetes is reversible, meaning blood sugar can go back to normal levels and insulin resistance can decrease according to the Center for Disease Control (CDC)

It is often possible to reverse prediabetes and insulin resistance without using medications. Instead, ways to lower blood sugar include losing weight if you are overweight or obese, increasing physical activity levels, and making other healthy lifestyle changes. Lark Diabetes Prevention Program can help with healthy behaviors to reverse prediabetes and prevent diabetes.

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What Are Diabetes and Prediabetes?

In diabetes and prediabetes, blood sugar levels are higher than normal. This happens because of a condition called insulin resistance. 

Insulin is a hormone in your body that is necessary for lowering blood sugar levels. Insulin helps muscle, fat, and other cells of your body take sugar (glucose) from the blood and use it for fuel and energy storage. If you have insulin resistance, it is harder for cells to use glucose. Instead, more glucose than normal stays in the bloodstream.

As insulin resistance progresses, prediabetes can develop. If prediabetes is not treated, type 2 diabetes is likely to develop within a few years. Having diabetes puts you at risk for complications.

What It Means to Reverse Diabetes

Reversing prediabetes means achieving normal blood sugar levels, and maintaining them without medications. Reversing diabetes means achieving blood sugar levels that are lower than in diabetes, that is, that are within normal or prediabetes levels. The potential to reverse diabetes is higher among people who have been living with diabetes for less time and who have better controlled blood sugar levels, but taking steps to manage blood sugar can be beneficial for anyone with high blood sugar.

How Many People Have Prediabetes?

Prediabetes is increasingly common. More than 1 out of 3 American adults have it, totaling about 88 million, according to the CDC. Of these, 85% do not know they have it, making them more vulnerable to diabetes since they are not working on reversing their prediabetes.

You can reverse prediabetes by making lifestyle changes that help you:

  • Lose extra weight.
  • Increase your physical activity levels.
  • Make dietary changes to improve cholesterol levels and lower blood pressure

If you are overweight, losing even a small amount of weight can help you reverse your prediabetes. Research published in the journal Diabetes Care has found that for every kilogram (2.2 pounds) of extra body weight you lose, your risk for diabetes decreases by an impressive 16%. While losing weight is not easy, it may be more doable when you set smaller goals such as a few pounds at a time.

Ways to Reverse Prediabetes Naturally

So, what can you do to reverse prediabetes? Most people can slow, stop, or even reverse insulin resistance with healthy lifestyle changes. The Centers for Disease Control and Prevention and Harvard School of Public Health suggest a variety of lifestyle changes that can lower blood sugar. Plus, they can lower blood pressure, improve cholesterol, and lower triglycerides.

Weight Loss for Preventing Diabetes

The National Diabetes Statistics Report from the CDC says that 89% of patients with diabetes have overweight or obesity. Thankfully, losing extra pounds can help reverse insulin resistance and lower the risk of developing diabetes. 

Participants in the National Diabetes Prevention Program (DPP) set goals of losing 5 to 7% of body weight – that is 8 to 12 lb. if you weigh 170 lb. and 11 to 14 lb. if you weigh 210 lb. This amount of weight loss can reduce your risk of developing diabetes by over 50%. Even losing a couple of pounds can lower your risk.

Establishing new healthy habits can help you lose weight and keep it off. You do not need to make dramatic changes to see results. Small changes that fit easily into your lifestyle can be enough to make a difference. These are some behaviors to be aware of that can help with weight loss.

  • Keeping a food log.
  • Drinking a glass of water before eating meals and snacks.
  • Drinking more water throughout the day, including a glass before meals and snacks.
  • Preparing more meals at home instead of purchasing restaurant food or other processed, ready-to-eat foods.
  • Sitting down to eat instead of eating on the run.
  • Eating vegetables first at meals.
  • Getting adequate sleep.

Weight loss is about cutting calories that you take in (eat) compared to calories that you use (burn). Limiting your calorie intake can help you lose weight, but it does not need to feel like a series of sacrifices. These are some easy ways to cut a few calories here and there. 

  • Using less salad dressing.
  • Using mustard instead of mayo on sandwiches.
  • Choosing water or unsweetened coffee or tea instead of sugar-sweetened beverages.
  • Taking smaller portions of desserts and grains.
  • Selecting reduced-fat instead of full-fat dairy products, and skinless chicken or lean meat instead of poultry with skin or full-fat meat.

With a few small changes on most days, extra pounds can start to come off. Better yet, they can stay off when you incorporate these changes into your lifestyle.

Reversing Prediabetes With Diet

Small changes to make your diet healthier can help lower blood sugar independent of weight loss. An article in Expert Review of Endocrinology and Metabolism describes several dietary choices that can help lower the risk of developing type 2 diabetes. They include the following.

  • Eating more non-starchy vegetables. 
  • Swapping processed meat for protein sources such as nuts, fish, egg whites, and beans.
  • Choosing water, decaffeinated black coffee, plain tea instead of soft drinks, energy drinks, and other sugar-sweetened beverages.
  • Choosing whole grains and fruit instead of refined sugars and other carbohydrates.
  • Choosing healthier fats, such as olive oil and nuts or peanuts instead of butter

You can also consider how you prepare and eat your food. These habits can help you lose weight and reduce other risk factors for diabetes.

  • Baking, grilling, steaming, and roasting instead of frying.
  • Serving yourself smaller portions of high-sugar, high-fat, and high-carbohydrate foods.
  • Cooking for yourself instead of eating out.

Choosing more nutritious foods and preparing them in healthier ways can help reverse insulin resistance and lower blood sugar.

Reversing Prediabetes With Exercise

Can exercise reverse diabetes? It can certainly help lower blood sugar, since physical activity directly increases insulin sensitivity. 

The Physical Activity Guidelines for Americans suggest that adults get at least 150 to 300 minutes per week of moderate-intensity physical activity. That is the equivalent of at least 30 to 60 minutes on most days of the week. It all counts, whether you do your 30 to 60 minutes all at once, or break it up into shorter sessions, such as 10 minutes at a time.

Examples of moderate-intensity physical activity include:

  • Brisk walking
  • Water aerobics
  • Leisurely cycling
  • Playing doubles tennis
  • Roller skating
  • Gardening and mowing the lawn

Alternatively, you can achieve the recommendations by doing at 75 to 150 minutes per week of vigorous-intensity physical activity. 

Examples of vigorous-intensity physical activity include:

  • Running.
  • Bicycling uphill or fast.
  • Swimming laps.
  • Kickboxing.
  • Circuit strength training.
  • Playing soccer or singles tennis.

You can also meet the recommendations by doing a combination of moderate and vigorous exercises. Harvard School of Public Health adds that physical activity trackers, or fitness trackers, can be helpful tools for increasing motivation to get active.

It is important to get your healthcare provider’s clearance before starting an exercise program, trying new exercises, or increasing your physical activity levels.

Other Ways To Reverse Prediabetes

Many other lifestyle changes can affect prediabetes. As you develop a diabetes reversal plan, there are a variety of lifestyle factors to consider.

Stress Management

Stress is not just in your head. It may be contributing to risk for diabetes! In a recent research study, published in the Journal of Medicine and Life, participants with higher levels of chronic stress had a greater risk of having high blood sugar. Possible reasons may include:

  • Changes in hormones.
  • Increased levels of inflammation.
  • Weight gain.

Stress can cause all of those, and more, symptoms.

It is not possible to eliminate stress, reducing and managing stress can lower inflammation and slow the progression of insulin resistance. Stress management techniques can include:

  • Deep breathing.
  • Progressive muscle relaxation
  • Imagery and visualization
  • Keeping a log.

Exercising, eating well, and having fun with friends and family can also lower stress levels.

Adequate Sleep 

The CDC states that adults need at least 7 hours of sleep per night, but more than 1 in 4 Americans does not achieve this amount. Why does that matter when talking about reversing diabetes? 

As a review article in Nature Reviews Endocrinology explains, sleep deprivation interferes with the actions of hormones, including insulin. Being short on sleep increases insulin resistance as well as weight gain, which further contributes to diabetes risk.

These are some ways to get more, and higher-quality, sleep.

  • Following a bedtime routine.
  • Setting an earlier bedtime that is consistent.
  • Sleeping in a dark, quiet, and cool room.
  • Exercising regularly, but not too close to bedtime.
  • Avoiding caffeine in the afternoon and evening.

Quitting Tobacco Use

Quitting smoking can also support healthier blood sugar levels because of the effects of nicotine. Nicotine, a chemical in cigarettes and other tobacco-containing products, can increase insulin resistance. Quitting smoking or tobacco can take 10, 20, or 30 tries, but help is available. Your healthcare provider can refer you to resources, many of which are available for free.

Limiting Drinking

Relationships between alcohol and blood glucose can be complicated, but one thing is certain: too much alcohol raises the risk of type 2 diabetes and other health conditions. Research published in the journal Diabetic Medicine found that men and women had a higher risk for prediabetes and type 2 diabetes with excessive intake. 

If you do choose to drink, tips for safer drinking include:

  • Limiting alcohol consumption to 1 (women) or 2 (men) drinks per day.
  • Always consuming some food when you drink alcohol.
  • Following precautions from the American Diabetes Association if you have diabetes, such as monitoring blood sugar, and letting your drinking buddies know what to do if you lose consciousness.

Social Support and Lowering Blood Sugar

All these lifestyle changes can be a lot, but having social support can help. In fact, the CDC lists social support as one of the most important parts of a plan to reverse diabetes. Examples include:

  • Walking with neighbors in the morning or evening, or with a coworker at lunch.
  • Calling a friend if you feel stressed.
  • Packing a healthy picnic and spending the day at the park with your family.
  • Joining an online support group.

Medication to Reverse Prediabetes

Taking medications to reverse insulin resistance and treat prediabetes can seem simple in comparison to taking actions such as watching your weight and food, focusing on activity and sleep, and trying to manage stress. Metformin (glucophage) is one of a few medications that are sometimes prescribed for patients with prediabetes.

However, a review article published in Diabetes, Obesity, and Metabolism concludes that medications are not a magic bullet for reversing diabetes. Potential drawbacks of prescription medications for lowering blood glucose include:

  • Cost.
  • Side effects, such as diarrhea, upset stomach, coughing, shallow breathing, and muscle pain.
  • Forgetting to take them properly.

Plus…they may not even work as well! Research has found that lifestyle changes such as weight loss and physical activity can be more effective than metformin at reversing prediabetes.

Still, medication can have benefits for certain patients. It is best to discuss all of your options with your healthcare provider and to follow your provider’s recommendations.

Blood Sugar Levels in Prediabetes and Diabetes

How do you know if you have prediabetes or diabetes? Only a blood test can be used to diagnose you with prediabetes or diabetes. Your doctor or a lab can test your fasting blood sugar or glycated hemoglobin (A1C) or give you an oral glucose tolerance test (OGTT) to see if you might have prediabetes or diabetes. The American Diabetes Association gives the following ranges for normal results as well as ranges that indicate prediabetes or diabetes.

Blood Sugar Levels in Prediabetes and Diabetes
Normal Prediabetes Diabetes
Fasting Blood Glucose (FBG)
Under 100 mg/dl
100 to 125 mg/dl
Over 125 mg/dl
Glycated Hemoglobin (A1C)
Under 5.7%
5.7 to 6.4%
Over 6.4%
Oral Glucose Tolerance Test (OGTT)
Under 140 mg/dl
140 to 199 mg/dl
Over 199 mg/dl

As you start to learn about prediabetes reversal, you may see a lot of references to “A1C” or the “A1C test”. The term is short for “HbA1C,” which refers to “glycated hemoglobin.” Glycated hemoglobin, or A1C, is a way to measure of how high your average blood sugar has been over the past two to three months. Glycated hemoglobin is the percent of hemoglobin in your body that has been glycated – but here is a breakdown.

  • “Hemoglobin” is the type of protein that carries oxygen in your red blood cells. It delivers the oxygen to the cells in your body as your blood circulates.
  • “Glycated” means that a sugar, or glucose, molecule, is attached. The glycation (or glycosylation) process can occur when there is too much sugar in your blood – that is, when blood sugar levels are high.

So, a higher A1C value means that more sugar (glucose) has been in your blood and has had a chance to attach to hemoglobin in your red blood cells. 

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Online Diabetes Risk Test

The online prediabetes test is located on the CDC’s website, and it takes only a minute to complete. First, answer the 7 yes/no questions.

Scoring Your Online Prediabetes Test

Next, see how many points you got for each question. You get 0 points for a question if your answer was, “No.” If you answered, “Yes,” you get the following numbers of points.

Then, add up the points you received on each question to get a total score.

Online Prediabetes Test Results

If your score is 0 to 2, great! It means you probably do not have prediabetes right now. Think about what you can do now to keep your risk low in the future.

  • Choosing more nutritious foods.
  • Limiting fatty and sugary foods.
  • Increasing physical activity levels.

If your score is 3 to 8, your chance of having prediabetes right now is low, but it could increase at some point, according to the CDC. What you can try to do is keep your risk low.

  • Maintaining or achieving a healthier weight.
  • Continuing to eat nutritious foods.
  • Getting more exercise, as long as your healthcare provider approves.

If your score is 9 points or over, you have a high risk of having prediabetes now. The CDC recommends that you talk to your healthcare provider. You can get a test to see if you have prediabetes.

Almost anyone can lower blood sugar or even reverse prediabetes, but it is a lot easier when you have a personal lifestyle coach like Lark in your pocket. Your Lark coach is available 24/7 through your smartphone to offer practical advice and encouragement, and to provide instant feedback when you log meals, exercise, and weight. Lowering blood sugar can feel natural as you earn celebratory badges for good choices and develop healthy habits.

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Lark Diabetes Prevention Program is designed to help you lose weight and make other healthy lifestyle choices by taking it one small step at a time. Lark uses established behavior change strategies to help you turn small changes into long-term habits for success. The program is based on a proven program from the Centers for Disease Control and Prevention (CDC) and is backed by experts in nutrition, weight loss, exercise, sleep, and stress management

Millions of Americans have health insurance that covers Lark’s Diabetes Prevention Program for eligible members, and you may be one of them! Click or tap here to find out whether you qualify. You may even get a smart scale and Fitbit at no cost to you while you get started on one of the most exciting and important adventures of your life!

Updated: 5/19/21