Remission, not reversal. The word matters, because it changes what you can reasonably expect.
Remission means your blood sugar is back in the normal range without diabetes medication. It's real and it's documented. In DiRECT, published in the Lancet in 2018, about 46% of participants were in remission at one year — driven mainly by substantial weight loss, not by anything exotic. Goldenberg's 2021 review in the BMJ found low-carbohydrate approaches produced stronger remission rates at six months than at twelve, which tells you something useful about durability.
Three limits, stated plainly.
It's most achievable early. The closer to diagnosis, and the more pancreatic function you still have, the better the odds. After many years it gets harder.
It has to be maintained. In DiRECT, only a minority of those who reached remission had held it at five years. Remission is a state you keep, not a line you cross once.
It doesn't happen for everyone. Some people do the work properly — the weight, the food, the training — and their numbers improve without ever reaching remission.
That last group is not a failure. Managing type 2 well, and protecting yourself against what it does over decades, is the outcome that matters. Remission is one good result. It isn't the only one, and treating it as the only acceptable finish line makes people quit when they're actually winning.
I still take Metformin. My stats are in good range. Those two facts sit together comfortably.
What to ignore: any program that guarantees remission, or puts a timeline on it.
One caution worth repeating: if your stats improve and your medication isn't adjusted, you can go too low. That's a conversation with your doctor, not something to manage alone.
Reply and tell me — is remission something you're working toward, or is steady management the goal for you? Both are legitimate answers, and I'm genuinely interested in the split.
— Alistair
PureNovus
Educational, not medical advice.