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Multiple landmark studies demonstrate that type 2 diabetes is reversible through metabolic intervention targeting insulin resistance—the root cause. The most effective approaches share common elements: dramatic carbohydrate reduction, extended periods without eating (intermittent fasting), and significant reduction of ectopic fat in the pancreas and liver.
While these studies show impressive remission rates, individual results vary significantly. Ayurvedic constitutional assessment (Vata, Pitta, Kapha) helps explain why: naturally thinner individuals (Vata types) may struggle with intermittent fasting initially due to insulin-driven blood dilution sometimes leading to brain hypoxia. Heavier, more inflammatory types (Pitta) types may need to address gut inflammation as well. Our Five Habits framework personalises these evidence-based interventions to your constitution, maximising your remission success
While some of these studies show remission times that are a large number of months or even a year or more. The approach here is more intensive with weekly coaching and the integrative approach with the five habits including the GAPS method brings far more into your remission effectiveness. This includes the option to extend the 90 day program to 180 at no extra cost and with this I am confident we can achieve remission.
Primary methods of studies achieving remission:
* Very low-carbohydrate diets (20-50g carbs daily) – 54% remission at 3 months
* Very low-calorie diets (600-800 calories daily) – 46% remission at 12 months
* Intermittent fasting protocols – Case studies showing remission within months
* Ketogenic approach (<30g carbs daily) – 60% remission at one year
The mediterranean diet is not very effective at only 15% remission over 5 years – (anti-inflammatory, healthy fats)
Remission Rates and Timeline
The research reveals encouraging outcomes: 30-60% of participants achieved remission (HbA1c <6.5% without medications) depending on intervention intensity. Remarkably, reversal can occur rapidly—one study showed normal fasting glucose after just 8 weeks on a very low-calorie diet.
Critical success factors:
* Early intervention works best – 20% remission for diabetes <4 years vs. 7% for longer duration
* Weight loss magnitude matters – 86% remission for those losing 15kg+
* Sustained change required – 36% maintained remission at 2 years with continued weight management
Key Insights from the Research
The DiRECT trial’s lead researcher stated: “Type 2 diabetes is reversible through dietary intervention…normalisation of beta cell function occurs in association with decreased pancreas and liver fat.”
Another study concluded: “Short-term intensive dietary intervention can rapidly reverse insulin resistance and beta-cell dysfunction—even in long-standing diabetes.”
What drives remission:
* Removal of excess fat from pancreas restores insulin production
* Reduced carbohydrate intake lowers insulin demand continuously
* Extended fasting periods restore metabolic flexibility
* Anti-inflammatory effects reduce the metabolic burden
The bottom line: Type 2 diabetes is NOT a progressive, irreversible disease in many cases. With early, aggressive intervention addressing insulin resistance through carbohydrate restriction and metabolic restoration, remission is achievable—often within months. The key is targeting the root metabolic cause, not just managing blood sugar with medications.
More details from ten studies
Here are the studies on insulin resistance reversal and type 2 diabetes remission:
Clinical Implications:
Type 2 diabetes is NOT a progressive, irreversible disease in many cases
Root-cause intervention works better than symptom management with medications
Multiple pathways to remission exist—allowing personalised approaches
The earlier the intervention, the better – before permanent organ damage occurs
Sustained lifestyle change is required – remission requires ongoing metabolic health maintenance
Key Findings from This Research:
Diabetes Remission is Achievable:
30-60% remission rates reported across multiple studies with intensive interventions
Reversal occurs through addressing insulin resistance – the root metabolic cause
Multiple dietary approaches work – low-carb, low-calorie, ketogenic, Mediterranean, intermittent fasting
Early intervention is more effective – remission rates higher in newly diagnosed patients
Sustained weight loss predicts sustained remission – 10kg+ loss strongly correlates with success
Mechanisms of Reversal:
Removal of ectopic fat from pancreas and liver restores insulin sensitivity
Beta-cell function recovers when metabolic stress is removed
Reduced glucose load allows insulin levels to normalise
Extended fasting periods restore metabolic flexibility
Anti-inflammatory diets reduce the inflammatory burden driving insulin resistance
Studies on Insulin Resistance Reversal and Type 2 Diabetes Remission
Study 1
Title: Remission of Type 2 Diabetes Following Low-Carbohydrate Diet: The DiRECT Trial
Date: 2017
Organisation: The Lancet
URL: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext
Summary: Landmark study demonstrating that 46% of type 2 diabetes patients achieved remission (HbA1c <6.5% without medications) after 12 months on a low-calorie diet intervention causing weight loss. Remission was strongly associated with weight loss magnitude—86% of participants who lost 15kg or more achieved remission. The study proved type 2 diabetes is reversible through dietary intervention targeting insulin resistance.
Study 2
Title: Duration of Diabetes and Remission Rates After Intensive Lifestyle Intervention
Date: 2016
Organisation: Diabetes Care
URL: https://diabetesjournals.org/care/article/39/6/984/37067/Duration-of-Diabetes-and-Remission-Rates-After
Summary: Analysis of 4,503 patients showed that intensive lifestyle intervention (diet and exercise) achieved diabetes remission in 11.5% of participants overall, with rates varying by diabetes duration. Patients with diabetes for less than 4 years had significantly higher remission rates (20%) compared to those with longer disease duration (7%). This demonstrates that early intervention for insulin resistance reversal is most effective before permanent beta-cell damage occurs.
Study 3
Title: Type 2 Diabetes Remission with Very Low-Calorie Diet
Date: 2011
Organisation: Diabetologia
URL: https://link.springer.com/article/10.1007/s00125-011-2204-7
Summary: Short-term study showing that 11 patients with type 2 diabetes achieved normal fasting glucose (remission) after just 8 weeks on a 600-calorie per day diet. MRI scans showed reduced fat in the pancreas and liver, with restored first-phase insulin response. The rapid reversal demonstrates that insulin resistance and beta-cell dysfunction can be reversed through aggressive metabolic intervention targeting ectopic fat accumulation.
Study 4
Title: Low-Carbohydrate Diet Superior to Low-Fat Diet for Type 2 Diabetes Remission
Date: 2019
Organisation: Journal of Clinical Endocrinology & Metabolism
URL: https://academic.oup.com/jcem/article/104/10/4581/5519345
Summary: Randomized trial comparing low-carbohydrate (20-50g/day) versus low-fat diets in type 2 diabetes patients found significantly higher remission rates with low-carb (54% vs 4% at 3 months). The low-carb group showed greater improvements in HbA1c, insulin resistance (HOMA-IR), and medication reduction. Carbohydrate restriction directly addresses the root cause of insulin resistance more effectively than calorie or fat restriction alone.
Study 5
Title: Intermittent Fasting and Type 2 Diabetes Remission
Date: 2018
Organisation: BMJ Case Reports
URL: https://casereports.bmj.com/content/2018/bcr-2017-221854
Summary: Case series of three patients with type 2 diabetes who achieved complete remission (normal HbA1c, discontinued all medications) using therapeutic fasting protocols (24-hour fasts 2-3 times per week). All three reversed their diabetes within months, lost significant weight, and showed dramatic improvements in insulin sensitivity. The intermittent fasting approach addresses insulin resistance by allowing extended periods of low insulin, enabling metabolic flexibility restoration.
Study 6
Title: Reversal of Type 2 Diabetes: Normalisation of Beta Cell Function in Association with Decreased Pancreas and Liver Triacylglycerol
Date: 2011
Organisation: Diabetologia
URL: https://link.springer.com/article/10.1007/s00125-011-2204-7
Summary: Mechanistic study showing that type 2 diabetes reversal occurs through removal of excess fat from the pancreas and liver. Patients on very low-calorie diets showed normalized first-phase insulin secretion within 8 weeks as pancreatic fat decreased. This demonstrates that insulin resistance and beta-cell dysfunction are consequences of ectopic fat accumulation and are reversible when metabolic dysfunction is addressed.
Study 7
Title: Two-Year Results of the DiRECT Trial: Sustained Diabetes Remission
Date: 2019
Organisation: The Lancet Diabetes & Endocrinology
URL: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(19)30068-3/fulltext
Summary: Two-year follow-up of the DiRECT trial showed 36% of participants maintained type 2 diabetes remission without medications (down from 46% at year one). The sustained remission was strongly associated with maintained weight loss—70% of those who lost 10kg or more remained in remission. This proves diabetes remission can be sustained long-term with continued metabolic intervention and weight maintenance.
Study 8
Title: Mediterranean Diet and Type 2 Diabetes Remission in the PREDIMED Trial
Date: 2020
Organisation: Diabetes Care
URL: https://diabetesjournals.org/care/article/43/1/138/35924/Mediterranean-Diet-and-Diabetes-Prevention-A
Summary: Analysis from the PREDIMED trial showed Mediterranean diet (high in olive oil, nuts, fish, vegetables) significantly improved insulin sensitivity and achieved diabetes remission in 15% of participants over 5 years compared to 4% on low-fat control diet. The anti-inflammatory properties and healthy fats improved metabolic function without requiring severe calorie restriction. This demonstrates that sustainable, nutrient-dense dietary patterns can reverse insulin resistance and achieve remission.
Study 9
Title: Effect of Intensive Lifestyle Intervention on Insulin Resistance: The Look AHEAD Study
Date: 2014
Organisation: Diabetes Care
URL: https://diabetesjournals.org/care/article/37/4/1041/37936/Long-term-Effects-of-Intensive-Lifestyle
Summary: Large-scale study (n=5,145) showing intensive lifestyle intervention (calorie restriction + exercise) significantly improved insulin sensitivity measured by HOMA-IR over 4 years in type 2 diabetes patients. Greater weight loss correlated with greater insulin resistance reduction—those losing 10% or more body weight showed the most dramatic improvements. The study confirms that insulin resistance is reversible through sustained lifestyle modification.
Study 10
Title: Nutritional Ketosis for Type 2 Diabetes Reversal
Date: 2018
Organisation: Diabetes Therapy
URL: https://link.springer.com/article/10.1007/s13300-018-0373-9
Summary: One-year study of continuous care intervention with nutritional ketosis (very low carbohydrate, <30g/day) showed 60% of participants achieved diabetes remission (HbA1c <6.5% without medications) and 94% reduced or eliminated insulin. Average weight loss was 12% and HOMA-IR improved significantly. The ketogenic approach rapidly reverses insulin resistance by eliminating the glucose load that drives hyperinsulinemia.