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Remission and Type 2 diabetes

Remission in people with Type 2 diabetes means that your blood sugar levels go back to normal and you don’t need to take diabetes medication any more. 

Type 2 diabetes is still a serious condition. It can be lifelong and get worse over time for many, but it doesn’t have to be like this for everyone.

Most people treat their Type 2 diabetes with medication, diet and exercise. But some people are able to stop taking medication and put it into remission. This can be life-changing.

We know diabetes remission is most likely nearer to your diagnosis and strongly linked to weight loss. So we know that remission is possible for people who are overweight – but we’re still researching how to put diabetes into remission for people who aren’t overweight

Some call this reversing Type 2 diabetes or even a cure, but we prefer the term remission because your diabetes can come back. And there’s no guarantee you will reach remission – the research so far suggests that it isn’t possible for everyone. But there are so many benefits to losing weight, not least reaching remission.

Here we’ll explain what aiming for remission could mean for you, how we’re leading the way with our ground-breaking research and share stories from more people like Karen who’ve put their Type 2 diabetes into remission.

“I feel in better shape than I was when I was younger. I feel strong and I’m happier in my own skin.”

Karen put her Type 2 diabetes into remission – read Karen's story

What is Type 2 diabetes remission?

Remission is when you’ve got normal blood sugar levels and your doctor says you don’t need to take any diabetes medication any more. But what’s normal? We’re working with international experts to agree this, but our researchers used an HbA1c level of 48mmol/mol (6.5%) or less to define remission. We've got more information about HbA1c levels and advice on how to bring them down.

And we don’t say diabetes reversal or cure. We use the term remission because Type 2 diabetes might come back – we don’t know if it’s permanent. 

We also don’t know enough about how being in remission affects your risk of developing serious complications, like heart disease, foot disease or sight loss. So it’s really important that people in remission keep getting regular check-ups, like eye screening.

How can you put diabetes into remission?

Evidence suggests that the key to remission is weight loss. Some people have done this through lifestyle changes and through surgery.

Losing around 15kg significantly increases your chances of remission.

To understand how losing weight can help someone go into remission, we need to understand why being overweight can lead to Type 2 diabetes. 

If someone’s carrying extra weight around their middle, fat can build up around important organs like the liver and pancreas. This makes it more difficult for those organs to work properly, leading to Type 2 diabetes.

But not everyone who develops Type 2 diabetes is overweight. There are other factors, like age, ethnicity and family history that play a role in our risk of Type 2 too. These factors influence how well the liver and pancreas work, and also where we store our fat.

We can’t change those things, but we can usually change our weight. 

Our scientists believe that just as storing fat around the liver and pancreas affects how Type 2 develops, losing fat affects remission. They want to find out if it can help the liver and pancreas to start working properly again. Get up to date with all our latest remission research.

Benefits of losing weight

It’s important to know that not everyone who loses weight will go into remission. If remission hasn’t happened for you yet, remember that losing as little as 5% of your body weight can have huge benefits for your health.

It can mean:

  • fewer medications
  • better blood sugar levels
  • a lower risk of complications.

All of these are important for a long and healthy life.

“We know that losing even 5% of your weight helps improve HbA1c, blood pressure levels and cholesterol. This can have a big impact on your overall health and how you feel."

Douglas Twenefour, our Deputy Head of Care

We've got lots of information about how to manage a healthy weight.

Diet and lifestyle changes for remission

So far, the strongest evidence suggests that a low-calorie diet could help people lose weight and go into remission. This comes from testing a low-calorie management programme in our DiRECT research study. But that doesn’t mean it’s the only option. 

We also know that some people in remission got there by losing weight through the Mediterranean diet, a low-carb diet or a healthy balanced diet. Everyone’s different and what works for some may not for others.

“I had a complete overhaul of my diet. Before everything was processed food, but now it’s all cooked fresh by me. That way I’ve got control of what goes in my mouth. And it’s much tastier!”

Karen changed the way she thought about diet and fitness

You can ask your GP for help with weight loss too. They’ll be able to see if there’s a weight management service in your area, where you’ll get support and advice from a dietitian.

Weight loss surgery for remission

Diets aren’t the only way people with Type 2 diabetes have gone into remission – some have had bariatric (or weight loss) surgery. About 30 to 60% of people who have bariatric surgery go into remission. And a few have stayed in remission for over 15 years. 

“Weight loss surgery for my diabetes has given me a second chance.”

Jason is in remission of Type 2 diabetes – read Jason's story 

Surgery isn’t something to take lightly, and is definitely no quick fix, but it should be an option for those who want it. At the moment, it can be really difficult to get a referral. So we’re working to try and make bariatric surgery more accessible for those who fit the criteria. 

Get all the facts on weight loss surgery.

Our research into remission

Thanks to our research funding, scientists have been busy investigating a new weight management treatment, which includes a low-calorie diet, to help people put their Type 2 diabetes into remission.

This ground-breaking study is called DiRECT, short for Diabetes Remission Clinical Trial, and the results have already inspired the NHS to pilot Type 2 diabetes remission programmes in England and Scotland. Get the latest on DiRECT.

“By the second day of the study I started getting more energy, by the third day I started feeling better. My taste even changed. By the end of it, my 16 tablets a day went down to zero, my blood pressure which was sky high went back to normal. I felt 10 years younger."

Tony, who took part in our DiRECT study and is now in remission

But lots of research so far has focused on people with Type 2 diabetes who are overweight – so will we need a different approach for people who aren’t? We’re funding another study to look at this, called ReTUNE. You help make this research possible – help us fund more.

If you’re in diabetes remission

There’s so much we still don’t know, like how long remission lasts for or how it affects your risk of diabetes complications in the future, but it’s an exciting prospect. Lower blood sugar levels, better blood pressure and better cholesterol all reduce the risk of complications – and remission ticks all three boxes.

In the meantime, keep going to your regular check-ups and speak to your healthcare team if you’re worried about anything or have any questions. We've got loads more information about what you're entitled to at your annual diabetes checks.

Will you share your story of remission to help inspire others? We’d love to hear from you, whether you’re in remission already or that’s your goal. All you have to do is fill out this online story form and we’ll be in touch.
 

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