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Are Diabetes and Insulin Resistance Reversible? The Facts.

Are Diabetes and Insulin Resistance Reversible? The Facts.

THE MEDICAL PROFESSION WOULD have you believe that diabetes is not reversible and only controlling your blood sugar with drugs or insulin will protect you from organ damage and death. But medication and insulin can actually increase your risk of getting a heart attack or dying.

The diabetes epidemic is accelerating along with the obesity epidemic, and what you are not hearing about is another way to treat it.

Type 2 diabetes, or what was once called adult onset diabetes, is increasing worldwide and now affects nearly 100 million people — and over 20 million Americans.

We are seeing increasing rates of Type 2 diabetes, especially in children, which has increased over 1,000 percent in the last decade and was unknown before this generation. One in three children born today will have diabetes in their lifetime.

Yet this is an entirely preventable lifestyle disease.

In a report in The New England Journal of Medicine, Walter Willett, MD, PhD, and his colleagues from the Harvard School of Public Health demonstrated that 91 percent of all Type 2 diabetes cases could be prevented through improvements lifestyle and diet.

Here, I want to review in detail this new way of thinking about diabetes and outline the tests I recommend to identify problems with blood sugar. Next I’ll tell you exactly how to prevent, treat, and reverse Type 2 diabetes.

The Road to Diabetes Starts Early

Diabetes is often undiagnosed until its later stages. Insulin resistance, when the body becomes resistant to the effects of insulin, is primarily what causes diabetes.

When your diet is full of empty calories, an abundance of quickly absorbed sugars and carbohydrates (bread, pasta, rice, potatoes, etc.), the body slowly becomes resistant to the effects of insulin and needs more to do the same job of keeping your blood sugar even.

High insulin levels are the first sign of a problem. The high insulin leads to an appetite that is out of control, and increasing weight gain around the belly.

High levels of insulin are warning signs — they precede Type 2 diabetes by decades.

Insulin resistance and the metabolic syndrome associated with it is often accompanied by increasing central obesity, fatigue after meals, sugar cravings, high triglycerides, low HDL, high blood pressure, problems with blood clotting, as well as increased inflammation.

These clues can often be picked up decades before anyone ever gets diabetes — and may help you prevent diabetes entirely.

If you have a family history of obesity (especially around the belly), diabetes, early heart disease, or even dementia you are even more prone to this problem.

Most people know about the common complications of diabetes such as heart attacks, strokes, amputations, blindness, kidney failure, and nerve damage. Some may even know that it increases your risk of dementia and cancers and can cause impotence.

Diabetes and pre-diabetes ARE reversible by aggressively changing lifestyle, nutritional support, and occasionally medications.

But most people don’t realize that insulin resistance or pre-diabetes can be just as bad causing heart attacks, strokes, dementia, cancer, and impotence — decades before you get diabetes.

In fact many people with pre-diabetes never get diabetes, but they are at severe risk just the same.

Living in Harmony with Our Genes

We were highly adapted to a nutrient-dense, low-sugar, high-fiber diet rich in omega-3 fats. But when we eat out of harmony with our genes, we turn on genes that promote diabetes.

Take Arizona’s Pima Indians, for example.

They were thin and fit 100 years ago, living on a diet of over 70 percent carbohydrates. They ate high-fiber, unprocessed plant foods and they had no diabetes or obesity.

Now, in just one generation, they are nearly all obese and 80 percent have diabetes by the time they are 30 years old!

That’s because they are eating food that turns on all the wrong gene messages — foods like sugar, trans fats, white flour, and processed foods.

Diabetes is Reversible: Diagnose Problems as Early as Possible

Diabetes and pre-diabetes ARE reversible.

New science shows that it’s possible, through an aggressive approach of lifestyle, nutritional support, and occasionally medications.

It is important to diagnose Type 2 diabetes early, but it is often not diagnosed until very late.

In fact, all doctors should aggressively diagnose pre-diabetes decades before diabetes occurs, and before any damage is done to your body. Damage begins with even slight changes in insulin and blood sugar.

Unfortunately, there is a continuum of risk from slightly abnormal insulin and blood sugar to full blown diabetes. This should be addressed as early as possible on the continuum.

In a recent study, anyone with a fasting blood sugar of over 87 was at increased risk of diabetes. The lowest risk group had a blood sugar less than 81.

Most doctors are not concerned until the blood sugar is over 110 — or worse, over 126, which is diabetes. Therefore, I recommend early testing with anyone who has a family history of Type 2 diabetes, central abdominal weight gain or abnormal cholesterol.

Don’t wait until your sugar is high.

Testing for Insulin Resistance and Diabetes

The tests I recommend include the following:

  1. Insulin Glucose Challenge Test – This should be done with a 2-hour glucose challenge, 75 grams measuring fasting, 1- and 2-hour blood sugar AND insulin. Your blood sugar should be less than 80 fasting and never rise above 110 or 120 after one to two hours. Your insulin should be less than 5 fasting and should never rise above 30 after one to two hours. I recommend this test for everyone over 50, and for anyone with any risk of insulin resistance, even children.
  2. Hemoglobin A1C Test – This is an important measure of glycated hemoglobin, which can be an early indicator of sugar problems. It measures sugars and proteins combining into glycated proteins called AGEs (advanced glycation end products), like the crust on bread, or the crispy top on creme brule. These create inflammation and oxidative stress throughout the body, and promote heart disease and dementia and accelerating aging. The hemoglobin A1C should ideally be less than 5.5. Anything over 6 is considered diabetes.
  3. Lipid Profiles – These are also important. An HDL or good cholesterol level under 60 and triglycerides over 100 should make you suspicious of insulin resistance. An HDL under 40 and a triglyceride level over 150 usually means diabetes.
  4. NMR Lipid Profile – This test is slightly different from the one above as it identifies the size of your cholesterol particles. With insulin resistance or Type 2 diabetes, you develop small LDL and HDL cholesterol particles. They are much more dangerous than larger particles and lead to increased risk of atherosclerosis or heart disease.
  5. High Sensitivity C-Reactive Protein Test – This is a measure of inflammation, one of the classic conditions that is both the cause and result of insulin resistance and diabetes. It should be less than 1, and is often associated with diabetes. In fact, anyone with a high C-reactive protein has a 1,700 percent increased risk of getting diabetes.
  6. Homocysteine Test – Homocysteine levels are often abnormal in people with diabetes. The test is a measure of folic acid deficiency. It should be between 6 and 8.
  7. Fibrinogen Test – This measures your risk of clotting, which can cause heart attacks and strokes. It is also a sign of inflammation and is associated with insulin resistance and diabetes. It should be less than 300.
  8. Check Ferritin Levels – These are often elevated in people with diabetes. It is a nonspecific marker of inflammation associated with the disease. It also can mean an overload of iron in the body. It should be less than 150.
  9. Uric Acid Test – Your level should be less than 6. Higher levels indicate problems with insulin resistance. This can lead to gout, which is related to insulin resistance and Type 2 diabetes.
  10. Liver Function Tests – Elevated liver function can result from insulin resistance. This is the major cause of fatty liver and elevated liver function in this country. This is entirely due to sugar and carbohydrates in our diet that cause fatty liver, liver damage, and even cirrhosis.

These are tests any doctor can perform and are covered by insurance.

In another blog, I will tell you how to prevent, treat, and even reverse diabetes. I have seen this hundreds of times in my patients and there is no reason you can’t achieve the same thing if you apply these principles.

Till then, remember what Michael Pollan said: “Eat food. Not too much. Mostly plants.”

Now I’d like to hear from you …

Have you been diagnosed with pre-diabetes or diabetes?

Have you been told that it is irreversible?

What steps have you taken to prevent diabetes?

Please leave your thoughts by adding a comment below – but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

To your good health,

Mark Hyman, MD

Mark Hyman MD is the Medical Director at Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

Comments (13)

  • I just found out that my very overweight mother of 78 has diabetes. She also has HBP and macular degeneration. I want to get her on the reversal diet right away and then on a maintenance diet. What exactly is the best course? I have heard that for a couple of months she should have 3 protein shakes a day and unlimited fruits and vegetables. Is that correct? If so, what protein powder would you recommend please. Thanks so much for your help. I am SO worried about her and want to get started reversing this right away.

  • My Cholesterol levels have recently spiked to a level that has alarmed my PCP. It appears she and the gastroenterologist have not made the connection to my type II diabetes. I know I didn’t realize this connection and have been trying to cut out unhealthy fats from my diet in order to reduce the numbers. I have also been prescribed statins to keep my cholesterol down. At this time because the increase, she discontinued the statins and apparently the numbers are down. I would definitely like to see what foods you recommend to correct the diabetes and the fatty liver problem. This has been going on for some time, but has never been this bad before. These doctors are part of GHC and have a protocol that they are expected to follow concerning how to treat my issues. If I take the responsibility of improving my diet and the goals are achieved, I see no problem of doing this as long as the symptoms improve. Which of your publications and foods are a part of your plan?
    Thank you for helping me. I am 80 and I’m not giving up. Any improvement will be better than none at all or further deterioration.

  • Thank you for all the great health info…. However I would like to email this directly from here with just a click however there is not a button says email to a friend !

  • Dr. Hyman, I work at a Health Insurance Company in Minneapolis and to say “These tests …. are covered by insurance” is not accurate. Before someone gets a huge bill, I would add a disclaimer that “These tests may or may not be covered.” Thanks! Deb

  • Dr. Hyman, your articles are extremely helpful. I was diagnosed.w pre diabetes. I did.not change my diet.eating junk food, carbs etc. Today I experienced for the first.time symptoms severe itching. Tingling hands and feet after consuming sweets and carbs. I immediately knew what was happening. I did not inherit this. Your articles.have given me hope. I am a carb junkie.and this will be difficult but.I am determined to turn things around. Thank ypu for providing this valuable information its incredible and are you.

  • I have a diagnosis of type 2 diabetes. My fasting was 180 at the time. I have exercised, lost weight and changed my diet to the one listed in the book “The Daniel Plan”. Within 1 month after starting the diet plan, my Triglycerides and fasting blood sugar were so low that my primary care doctor asked me “what did you do?”. He could tell that I had made a change and he was very impressed. I have been on other diets and have lost weight and my blood sugar improved as well as the cholesterol and triglycerides. My biggest change was starting the “Daniel Plan”. In spite of the fact that I’m extremely stressed with a husband currently in hospice and my day is extremely busy, I find that eating healthy has helped me to get through all of the things that I’m currently dealing with. My aches and pains have decreased a lot and when I start eating the wrong foods (white flour, white sugar) (listed in the Daniel Plan), my aches and pain return quickly.
    I am a am walking proof that this Daniel Plan or eating healthy is the only way to go to be healthy and feel better.
    I am no longer on diabetes medication and I’m taking less blood pressure medications. This was without exercise which I know (an the book states) is essential to health. I am currently working on exercise and trying to fit it into my busy day.
    I have no website (it was required for me to send you a reply)
    My experience from my lab results show that type 2 diabetes is reversible (A1C is normal) but I know that I have to change my diet for the rest of my life. No more junk food and exercise.

    I used to need statins but had horrible reactions to them. This is when my doctor said that I had to lower my cholesterol by diet.

  • My frustration is that because my A1C is always fine, most recently 5.4, none of my doctors are ever worried or do anything about insulin resistance. However, I have central obesity, PCOS, the dark marks around my neck, high triglycerides, and lowish HDL (42). Most recently they found stenosis in my carotid (<50%, but echogenic and irregular), and I'm only 35! Frankly, like many people, I want everything to be OK and I have often been overly reassured after my doctor's visits due to their lack of concern, but I think this is crazy! Do generalist doctors just not understand insulin resistance and metabolic syndrome? Of course, I do get the advice to lose weight, but with no further guidance.

    Thus, I need to move past my own avoidant ways and figure out how to take this seriously even if my doctors do not.

    • Rebecca…..the answer to your question is not generally. Unless you get a good one! It took me years and years of putting on weight, my doctor putting me on diet pills that didn’t work, checking my thyroid with normal results, and then sudden weight gain while breast feeding for my doctor to give in to my pleading and refer me to an endocrinologist.

  • Hi Mark

    Do you have any dietary recommendations for people diagnosed with Gestational Diabetes?

  • i was diagnosed with 300 sugar reading 2 months ago.Just want to share what I did…as of today my reading is 87 even after 2 hrs of eating.Seems I was able to reverse it…without being insulin dependent which my doctor suggested to take after that yealy checkup reading of my sugar…i told him let me do exercise first and diet. my weight was 210 lbs im 5 9 and 38 yrs old. first month trimmed downed my weight to 185 lbs i know its fast but if you have will power you can actually do it…did running 4km per day for 1 month…stop soda or fast food..only water…lunch just eat salad…no rice for me for one month. nigh time just eat soups with vegetables and a bit of meat/fish for protein…secret is once you feel full stop the saying goes you are what you eat…eat more fruits and vegies greener the better…stopped eating processed foods and no fried foods. Did a detox for one month colon cleansing and cholesterol detox…drank mostly herbal medicines…seems effective for me. Second month did weights trainign to remove fats and improve my cardio…15 mins 6.5km/hr then 1 hr weigths training and 10 mins everyday for the second month.based on my research…we need to kill diabetes by improving our pancreas…this is the cause of high sugar as pancreas cannot work as what they should be doing…to excrete more insulin to our body…in my understanding…more muscles more improvement on my condition…my doc said I am pre-diabetic already and need to take medications…but i think i proved him wrong…YES….i think diabetes is reversible….just need the will power to improve our pancreas by making ur weight ideal and diet… im very happy with my daily 85 to 110 sugar reading now…if i can do it you can also…pm me at for questions..glad to help out.cheers 🙂