Heart & metabolism
Type 2 diabetes
High blood sugar, a diabetes diagnosis, or a worry about "reversing" it: what is true, and what should I check?
In type 2 diabetes the body does not make enough insulin or does not use it well, so blood sugar stays too high. It can be managed with a care plan, medicines when needed, and regular checks. Remission is possible for some people, but it is not a cure.
In 30 seconds
The short answer
In type 2 diabetes, the body does not make enough insulin or does not use it well, so too much glucose stays in the blood.1 Symptoms often develop slowly and many people have none, so a blood test is how it is found.38 It is managed with a plan made with your health care team: a meal plan, activity, sleep, the A1C test, and medicines taken as prescribed.121415 Yearly eye, kidney and foot checks catch problems early.303234 Some people reach remission, but it is not a cure and checks continue.383940 This is education, not medical advice. Do not stop or change diabetes medicines without your clinician.
What type 2 diabetes is
What happens in type 2 diabetes
A simplified illustration based on NIDDK.
Risks and prevention
What raises and lowers the risk
Raises the risk
Low blood sugar
If blood sugar is low
Based on NIDDK. Ask your team what is low for you.
Remission is not a cure
What remission means, and what it does not
What it means
Medicines, supplements and safety
A pharmacist can review your diabetes medicines, explain low blood sugar risks and check for interactions.17 A pharmacist does not diagnose diabetes or set your A1C goal.
- Take diabetes medicines as prescribed, even if you feel good. Do not stop or change them on your own; talk with your health care team.15
- Insulin, sulfonylureas and meglitinides can cause low blood sugar.19 Ask your team before big changes in eating, fasting or activity.204143
- Over time you may need more than one medicine, and sometimes insulin.16
- No special diet, supplement or detox is a reason to stop prescribed medicines; remission is judged by an A1C test after a clinician has stopped them.3839
Compared
Conventional and integrative care, compared
What diabetes medicines do, their main danger, what drives type 2 diabetes, and where lifestyle and remission research stand.
What conventional treatment does
- Diabetes medicines may include pills or injected medicines such as insulin, and over time more than one may be needed.16 The targets are the diabetes ABCs — A1C, blood pressure and cholesterol, plus stopping smoking; for most people the A1C goal is below 7 percent.12
- Medicines are taken as prescribed even when you feel well or have reached your goals; cost or side effects are reasons to talk to the team, not to stop.15 A pharmacist can be part of that team.17
Limits and adverse effects
- Low blood sugar is common in people who take insulin or some other diabetes medicines; two kinds of pills can cause it, sulfonylureas and meglitinides.19 Skipping meals, fasting while still taking medicine, or being much more active than usual can trigger it.20
- Low blood sugar can make you shaky, hungry, tired, dizzy, confused or irritable; very low blood sugar can cause loss of consciousness or a seizure.21 If lows are frequent, the meal plan, activity or medicines may need to change — a decision for the care team.43
What contributes to the condition
- Several factors cause type 2 diabetes, including overweight, not being physically active, insulin resistance and genes.5 Insulin resistance means the cells in muscle, fat and liver do not respond well to insulin.6
- Risk is higher with overweight, age 35 or older, a family history, physical inactivity or prediabetes.4 Symptoms often develop slowly over years and may be absent.3
Integrative and naturopathic approaches, by evidence
Evidence levels: EstablishedEmergingHypothesisNot supported
- Established
If you are at risk, losing 5 to 7 percent of your weight and getting at least 30 minutes of activity most days may prevent or delay type 2 diabetes.7 A meal plan made with the care team and at least 150 minutes of activity a week are part of management.14
- Emerging
A 2021 expert consensus defines remission as an A1C below 6.5 percent at least 3 months after stopping glucose-lowering medicine;38 the same report calls "cure" a problematic word, because follow-up is still needed.39 Even in remission, eye, kidney, nerve and heart complications can still occur, so screening continues.40
- Hypothesis
Claims of reversal programs that go beyond this definition — including the clinic's "freedom from diabetes" plan on the insulin-resistance page — are not supported by a source or study we could check.
Remission is reached with a care team watching glucose and medicines; stopping medicine on your own to "reverse" diabetes is dangerous.
When to get help now
Each warning sign cites the official guidance behind it. The wording still needs pharmacist sign-off.
- Very low blood sugar: you pass out, have a seizure, or cannot treat it yourself — it needs treatment right away; others should call 911.212324
- Signs of diabetic ketoacidosis: very tired, trouble breathing, fruity-smelling breath, belly pain, nausea or vomiting — a medical emergency that needs treatment right away.2627
- A foot cut, blister or bruise that does not start to heal after a few days, or red, warm, painful skin — call your health care provider right away.31
- Sudden vision changes, flashes of light, many new floaters or a curtain over your eyes — call a doctor right away; it can be a medical emergency.33
- Chest pain or pressure, shortness of breath, or sudden weakness, confusion or trouble talking — call 911 right away.3637