A new type 2 diabetes diagnosis can be frightening. Many people want their diabetes to go away, and they do not want to take medication. As as dietitian, I often am asked by people with diabetes if I can help them make their diabetes go away. My short answer is, no, I can't. And it is not for lack of diabetes nutrition knowledge! Here is why.
Type 2 diabetes is not considered a condition that can be cured. It is a condition that can be put into remission though. Once a person is diagnosed with diabetes, they hold that diagnosis for life. The reason for that is because blood sugars high enough to reach a diagnosis of type 2 diabetes occur after beta cells in the pancreas are damaged--a key feature of type 2 diabetes, and that process is not reversible.
What is possible, at least for some people, is to maintain blood sugars within the goal range with using only nutritional and lifestyle interventions. This does not mean diabetes is cured. It merely means that the disease is managed, or put into remission, with diet and lifestyle interventions. This is more likely to be successful at the earlier stages of diabetes. As diabetes progresses, the underlying mechanisms that lead to elevated blood sugar progress to a point where nutrition and lifestyle alone will not bridge the gap between a person's blood sugar levels and their goal blood sugar levels.
Because diabetes is a progressive condition, a person with near perfect nutrition may eventually find that their nutrition and lifestyle won't maintain their blood sugars in goal range. Fortunately, there are many medications for diabetes--numerous classes of medication, and numerous options within classes of medication.
Needing medication for diabetes is not a personal failing. It is just a reality of a progressive chronic disease. Elevated blood sugars in the context of an appropriate diet should not be an indicator to further restrict food intake. It is only an indicator that medication is now necessary.
Delaying starting diabetes medications in the hope that nutrition will eventually solve the problem of high blood sugar can be harmful for some patients. The longer blood sugar levels are elevated, and the higher they are elevated, the more likely diabetes complications are to occur. Because of this, it can often be reasonable to start medication right at diagnosis, and if nutrition interventions are proving efficacious, medications can then be stopped. For many patients this is even the best way to treat diabetes, as the risks of elevated blood sugar are greater than the potential downsides of taking diabetes medications.
I am a dietitian, and it is important for me to understand what nutrition can do and when other interventions are needed. I love good nutrition. I think good nutrition is crucial whether or not a person also needs medication for their diabetes. People with good nutrition have better health outcomes, regardless of if they also need to take medication for their diabetes. Still, good nutrition will not cure your diabetes.
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