PREFACE

WHAT DOES IT MEAN TO REVERSE DIABETES?

In 2003, a man came to our research center at the Physicians Committee for Responsible Medicine to join a study on type 2 diabetes. His family had suffered enormously from the disease, and he had been diagnosed at the age of 31. When he began the study, his blood sugar was elevated, and he had a great deal of weight to lose. But as he began to follow a low-fat, plant-based diet under our direction, everything changed. Excess weight melted away, and his blood sugar came down. And down. And down. As the weeks went by, his personal physician was impressed by his progress and stopped his diabetes medication. He just did not need it anymore. Eventually, his blood tests improved to the point that there was no trace of diabetes left. He was on no diabetes medications at all, and his blood sugar was squarely in the normal range.

This raised a question: What should we tell him? I had been taught—as you may have been, too—that diabetes never goes away. “Once you have diabetes, you’ll always have diabetes,” was what people said. And yet here was a man who had had diabetes for years, but who was now on no medication and who had perfectly normal blood sugar. He could walk into any medical clinic in the world and no one would have guessed that he had ever had the disease. Should we tell him that his diabetes was gone?

As time went on, that question became easier to answer, thanks to our surgical friends. Patients who lose hundreds of pounds after bariatric surgery often find their diabetes disappearing, so doctors have become more comfortable with the notion of type 2 diabetes being a two-way street. Many have found that, when people lose a great deal of weight or make big changes to their diets, the blood tests can, in some cases, show a return to the normal range.

However “reversing” is not a medical term. When I speak of “reversing type 2 diabetes,” what I mean is that the disease process turns around. Weight that has been steadily rising starts moving in the opposite direction. Cholesterol and blood pressure numbers that have been steadily going up begin falling. Blood sugar values that have been hard to control finally begin to drop, too—often to the point where medications must be reduced or stopped. Sometimes type 2 diabetes improves so much that it is simply no longer detectable. And complications, such as painful neuropathy, can release their grip, too.

Remember: Type 1 diabetes is different. It requires continued insulin treatments, regardless of how well you adjust your diet. Nonetheless, diet changes are very helpful for type 1 diabetes, too, as we will see shortly.

For any individual, it is not possible to know in advance how much your diabetes will improve. So the thing to do is to get started. I wish you every success with this powerful program!