If you're living with type 2 diabetes, finding a treatment plan that works to manage or reverse the condition is sure to rank high on your list of priorities. Unlike type 1 diabetes, which is a lifelong condition, there is significant evidence to suggest that certain factors can send type 2 diabetes into remission, meaning people with diabetes no longer need to rely on medication to manage the condition.[1,2] Remission doesn’t guarantee that type 2 diabetes won’t develop again later in life but the chances are greatly reduced if healthy habits and treatment plans are continued after a patient has gone into remission.

We’ll explore some of these habits and treatment plans below.

Type 2 diabetes treatment guidelines: lifestyle changes

One of the most effective ways to manage type 2 diabetes is by making changes to your lifestyle.

Being overweight is one of the many risk factors for type 2 diabetes. This is because excess fat in the liver and the pancreas stops the organs from producing insulin or regulating blood sugar levels properly. But, life-changing research has shown that losing a significant amount of weight—an average of 15kg—helps to clear fat from the organs so they can regain the ability to process sugar.[3,4] Lifestyle changes such as diet, physical activity, and habit formation are all effective ways to help you maintain a healthier weight—and naturally improve blood sugar control.

Type 2 diabetes can be reversed in up to 60% of people with lifestyle interventions

Taheri et al., Lancet

Diets to manage and treat type 2 diabetes

First things first, it's important to know that there isn’t a single type 2 diabetes diet that everyone with the condition should absolutely follow. How you eat depends on your lifestyle, budget, health goals, and personal preferences.

If you’re looking to lose a significant amount of weight quickly and safely then a total diet replacement (often referred to as a TDR) diet might be the best option for you. Hailed as the most effective method for weight loss and type 2 diabetes remission,[5] TDR is a low-calorie diet made up of nutritionally balanced, powdered meals that can be taken for up to 3 months; they’re completely safe and the end results can be life-changing.

Of course, while TDR is a powerful method for weight loss and the all-important habit change, it isn’t necessarily right for everyone—the most effective diet to reach remission is the one that suits you. Other options include low-carb, keto, and veganism (to name a few!), not to mention flexible approaches such as intermittent fasting.

Increase your everyday activity

Alongside diet, exercise is an important part of any diabetes treatment plan. There are plenty of benefits to exercising but one of the most important for people with diabetes is its ability to lower blood sugar levels. As we exercise, our bodies use sugar as a fast-acting energy source, drawing sugar from reserves found in the muscles and liver. After exercise, our bodies replenish these stores with sugar from the bloodstream for up to 48 hours after exercising.[6] 

If you’re new to exercise, or the thought of lacing up your trainers fills you with dread, fear not. Start small—take the stairs instead of waiting for the lift, get off the bus a stop earlier, or walk shorter distances rather than drive. Little swaps can amount to big changes and once you realise exercising isn’t quite so scary you can begin to increase your heart rate by going for brisk walks, light jogs, swims, or cycle rides. And don’t forget, activities such as heavy gardening, carrying shopping bags, or even cleaning the house all get your muscles moving!

Create new habits 

We understand that losing weight is easier said than done, which is why we champion the importance of habits—and taking the time to develop healthy, sustainable ones that will help you lose weight that stays off. By investigating your relationship with food and why certain eating habits might be harming you, you might discover you’re an emotional eater, using food as a comfort when times are tough. If this is the case, then adjusting your diet is only going to do so much. Instead, you will need to understand why you're using food as a coping mechanism and work at addressing this issue first.

Once you have a better understanding of why you eat, you can then start implementing new habits that feel supportive rather than restrictive. By rewiring our brain (it’s not as scary as it sounds!) and challenging old thought patterns we can then begin to make empowered, healthy choices.[7] 

A useful exercise is to think of who we want to be. Identity-based habits are a powerful way to achieve your health goals as rather than think of outcomes (losing weight) and processes (avoiding sugar), they focus on the type of person we want to be.

With a clear understanding of our identity, we can start building habits that become a part of who we are rather than things we do for a short period of time. For example, every time you eat more veg, you’re becoming the type of person who eats less meat, or every time you go for a walk, you’re becoming someone who runs 5k.

Eat a balanced diet

Eating well is a key part of losing weight, which helps stabilise blood sugar levels and can contribute to type 2 diabetes reversal. After losing weight initially, following a well-balanced, nutritious diet is key to keeping the weight off and—if you manage to reverse type 2 diabetes—reducing the risk of the condition developing again. 

The food you eat is a key factor in managing your blood sugar levels. Foods high in carbohydrates—particularly starchy carbohydrates—will raise your blood sugar levels so you will need to limit the amount you eat throughout the day. Not all carbs are created equal so be sure to understand the difference between simple and complex carbs, and how these can affect blood sugar levels.

Try and favour a diet rich in fresh vegetables, nuts, pulses, lean proteins, and fresh fruit;[3] the emphasis should be on nutritious foods that nourish your body and help it to function as well as possible. When it comes to plating up meals try and visualise what a healthy plate looks like; the majority of your plate should be taken up with vegetables, equal amounts should be given to whole grains and healthy proteins, and a smaller portion should be allotted to whole pieces of fruit.[8] If you’re looking to cut down on sugar, a good place to start is by reducing your intake of processed foods—there’s hidden sugar in a lot of our daily ‘go-tos’, so take the time to look at food labels, seek out low/no sugar alternatives, or consider making your own homemade version of your favourites!

Type 2 diabetes treatment guidelines: medication

So far we’ve examined treatments for type 2 diabetes that focus on lifestyle changes but after a diagnosis, it's common for doctors to prescribe medication. 

Certain medications can control blood sugar levels and help to keep them at a normal, healthy level. Your doctor will be able to prescribe a medication best suited to your needs but one of the most common medications for type 2 diabetes is called metformin.[9] Metformin works by reducing the amount of sugar that the liver releases into your blood as well as helping the body to respond better to insulin. 

Your dose of metformin may change; if your blood sugar levels aren’t going down even with medication or if your blood sugar levels change drastically over time you might need an increased dose or a combination of medication. Again, your doctor will advise the best course of action for you and ensure that your medication levels are slowly adjusted.

Insulin

In some cases, you might be prescribed insulin to help manage your blood sugar levels—this often only happens if other treatments haven’t been successful. Taking insulin keeps your blood sugar levels in a healthy range and prevents complications that can arise from diabetes. Your doctor will explain to you how and when to take your insulin.

Medication and living a healthy lifestyle

Medication has come a long way since its use for managing type 2 diabetes. If taken correctly it can manage the effects of the condition and control your blood sugar levels. Unfortunately, you will need to take metformin, or other similar medications, for the rest of your life and we understand that being reliant on medication can make you feel powerless. There are other concerns too, such as remembering to take your pills correctly and having to swap and change your dosage if your condition changes.

After one week on TDR, patients’ blood sugar levels fell to within a normal range

Lim et al., Diabetologia

While medication helps keep blood sugar levels within a healthy range, it doesn’t treat the underlying causes of type 2 diabetes. Alongside taking medication you should also look at implementing healthy habits that help manage the condition; things we’ve explored earlier in this article, such as losing weight, working out, and eating well. In many cases, patients are able to use these lifestyle changes so they can stop taking medication completely and reverse the effects of type 2 diabetes through a healthy, well-balanced lifestyle.

Treatment for type 2 diabetes—final thoughts

While there isn’t a quick fix when it comes to reversing type 2 diabetes, adopting healthy habits and taking medication correctly can help manage the effects of the condition. It’s important to discuss your treatment plans and options with your doctor who will be able to advise you on the best course of action that is most suited to your needs.