The good news about diet and diabetes

At least a quarter of a million New Zealanders live with diabetes - a disease which causes a huge social and economic burden - and that number is rising.

The prevalence in Māori and Pacific peoples is about three times higher than other New Zealanders, and is also high among South Asian peoples.  

So is it possible to reverse diabetes? 

Before we answer that, let’s first untangle the disease. Diabetes is the result of the body not creating enough insulin to keep blood glucose (sugar) levels in check.

Everyone needs sugar in their blood, but if it’s too high it can damage your body over time - harming organs and blood vessels, which can lead to heart attack, stroke, and problems with lots of parts of your body including your eyes, kidneys, and even your feet. 

Type 1 diabetes (making up about 10% of cases) is an autoimmune condition. The body essentially attacks the cells in the pancreas that make insulin, meaning the body cannot make enough of it. Type 1 diabetes usually starts in childhood, and cannot be prevented. 

Type 2 diabetes is different. Blood sugar levels are too high because people either aren’t making enough insulin (from the pancreas) to manage blood sugar levels, or the cells in the body don’t recognise insulin, so don’t take in enough sugar from the blood stream. 

The reasons why this happens are complex, but being overweight and inactive are key contributing factors. But for most people, it can be prevented. 

Diabetes can’t really be reversed, because even with the best management, the disease can return at any time. But some people will be able to achieve remission of Type 2 diabetes. 

It is possible that through weight loss and management of diet, a person with Type 2 diabetes can get their blood sugar levels to stabilise, to the point they no longer need to take medication. 

There is good evidence that if a person is obese, their diabetes is more likely to go into remission if they lose weight as safely as possible following diagnosis. 

Information about diabetes and weight loss often throw around 15 kilograms as a target. This is largely due to the fact that studies into weight loss and diabetes remission have aimed for people to lose 15kgs. 

However, even modest weight loss can improve a person’s diabetes, according to endocrinologist and Professor of human nutrition at the University of Otago, Jim Mann. 

Professor Mann explains that it is possible for a person’s diabetes to improve with a smaller amount of weight lost, but for others it may require more. 15kg is not a “magical measurement”. 

Diet and weight loss will also not ‘reverse’ diabetes for late-onset type 1 diabetes, post-surgical, trauma diabetes or monogenic diabetes (a rare condition resulting from mutations to a gene). 

A person may also be too far down the course of their disease - their pancreas could be more worn out, for example - for them to reach remission. 

But many people can live a long, healthy and productive life with diabetes - regardless of whether it is type 1 or 2 - with the right management. 


Reporting disclosure statement: This post was written with expert advice from Professor of human nutrition, Jim Mann. It was reviewed by The Whole Truth: Te Māramatanga expert panel member Dr Jason Gurney.