Can You Reverse Diabetes?

From competitors on TV's The Biggest Loser announcing that they've put type 2 into remission to headlines promising a cure for type 1, many wonder: Can you cure diabetes? Can you change your diabetes fate?

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Scott Sutton had a lot of questions after the 31-year-old was diagnosed with type 2 diabetes last year. Among the first: Is it curable?

"Absolutely," was his doctor's reply. "He told me that I was very fortunate to have caught it at my age, because it was entirely up to me at this point," Scott says. "He told me he could envision a day that I no longer needed medication, provided I make the necessary changes."

The word cure comes up a lot these days, from NBC TV's The Biggest Loser to websites that tout diet plans promising to reverse type 2 diabetes. Is it just semantics? Or can you really cure your diabetes? For answers, we talked to experts and people who have taken dramatic steps to manage their diabetes.

You can't rewrite history

It's key to understand that type 2 diabetes is a progressive illness often preceded by years of prediabetes. When most people with type 2 diabetes are finally diagnosed, experts believe they've been on this path for five to 10 years and have lost more than half of their natural insulin-making capability.

"A decade-plus of research from the National Institutes of Health's Diabetes Prevention Program in prediabetes shows that people who lost some weight, initiated exercise, and engaged in minimal support delayed the onset of type 2 by only about four years," says Sue Kirkman, M.D., an endocrinologist and senior vice president for Medical Affairs and Community Information for the American Diabetes Association (ADA).

To control blood glucose (also known as blood sugar) over years, people with type 2 diabetes must pair a healthy lifestyle with glucose-lowering medications. On the upside, Kirkman says, there are health benefits to having normal glucose levels for as many years as possible.

Time for action, not defeat

Don't despair and don't give up. While you cannot undo your lifestyle habits of the last decade, you can take steps to put your diabetes in remission.

Research shows that losing weight and keeping it off can help delay the onset of prediabetes, delay progression of prediabetes to type 2 diabetes, or slow the progression of type 2. The keys to diabetes prevention and preventing diabetes complications include: Eat healthfully, exercise often, seek out knowledge and support, and create an environment that fosters healthful living.

Losing even just a few pounds early on when glucose begins to rise can dramatically improve glucose levels, cholesterol levels, triglycerides, blood pressure, and more. However, the amount of weight experts say you need to lose overall remains controversial.

"People should get to their ideal weight if they have prediabetes or type 2," says Rob Huizenga, M.D., associate professor of medicine at the University of California, Los Angeles and doctor for The Biggest Loser, where he is known as Dr. H. "People should have no excess fat and be athletically fit. Ninety minutes of exercise six days a week and a steady diet of healthy eating is the best prescription to manage type 2 diabetes without medications."

That's easier said than done for most people, who have to adopt a healthier lifestyle outside the bubble of the ranch where The Biggest Loser is filmed or the jump-start of a stomach-shrinking surgery.

Many research studies suggest a goal of losing 5-7 percent of your starting weight to lower glucose and improve health, with the imperative to keep the pounds off.

When The Biggest Loser Season 12 contestant Ramon Medeiros arrived at the ranch in June 2011, he weighed just over 350 pounds on his 5-foot-11-inch frame. "I was aware of my family type 2 diabetes history, but not aware I had diabetes," he says.

With high blood sugar, blood pressure, and cholesterol, as well as sleep apnea and other conditions, Ramon, 28, recounts Dr. H calling him the sickest guy on the ranch. "Hearing that was tough," Ramon says. He lost 150 pounds -- and has kept it off -- and now works as a trainer at The Biggest Loser Resort in Java Center, New York. He considers his type 2 diabetes reversed.

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