Type 2 diabetes is a chronic disease. The longer you have it, the more it can negatively affect your health.

For the majority of people with type 2 diabetes – there are steps you can take to live well while managing this condition.

But research is showing that some people can even put the condition into remission.

We spoke to Susie Jin to learn more about diabetes remission – what it means and what’s possible. 

Jin is a pharmacist and Certified Diabetes Educator. She is also on the Diabetes Canada Clinical Practice Guidelines Expert Committee.

What is type 2 diabetes remission?

Jin explains that type 2 diabetes remission occurs:

  • When your blood sugar levels are below the diabetes range,
  • for more than three months,
  • without the help of medication to lower your blood sugar.

In medical terms, Jin says there are two distinctions:

  • Remission to prediabetes occurs when your A1C level is between 6.0 and less than 6.5.
  • Remission to normal blood sugars occurs when your A1C level is below 6.0.

Remission is not a cure. But, Jin says, it involves maintaining your blood sugar levels at (or close to) normal levels. 

This means it minimizes or even reverses a person’s risks of developing complications. 

“It doesn’t mean your diabetes has gone away forever. Your blood sugar levels can rise again. But it does mean that you’re more likely to feel better. And you’ll see long-term improvements in your health.”

What are the benefits of type 2 diabetes remission?

As Jin explains, having an A1C below the diabetes range of 6.5% is a key benefit. It can reduce your chances of developing diabetes-related complications. 

These complications include:

  • Heart attack
  • Stroke
  • Kidney disease
  • Eye disease

Other benefits (related to weight loss) include a reduced risk of:

  • Fatty liver disease (now known as metabolic dysfunction-associated steatotic liver disease, MASLD)
  • Obstructive sleep apnea
  • Reflux disease
  • Osteoarthritis
  • Certain cancers
  • Heart failure
  • Urinary stress incontinence and more

“You can achieve these benefits whether you’re managing your health with glucose-lowering or weight-lowering medications, or not,” Jin explains.

She also notes that health-care providers will provide guidance and treatment that is tailored to the patient’s preferences.

How can I put type 2 diabetes into remission?

“All the evidence we have right now shows that weight loss is the key to putting type 2 diabetes into remission,” says Jin. 

“This is because weight loss reduces fat that surrounds our pancreas and liver. This allows the organs to work as they should to maintain healthy blood sugar levels.”

According to the Diabetes Canada Guidelines, three medically-supervised approaches can potentially put type 2 diabetes into remission:

  • Bariatric surgery (for those with a BMI of 35 or higher)
  • An 800-850 calorie-a-day diet (with meal replacement products), for three to five months. This is followed by a structured food re-introduction program and more physical activity.
  • Exercise training (240-420 minutes a week) and a calorie-restricted diet (for those with a BMI greater than 25)

All three of these methods are very intensive. They are conducted with the close support and oversight of a medical team.

Any intervention that results in a weight loss of 15% or more could lead to non-diabetes glucose levels, says Jin. This would also be considered remission.

Who is a good candidate for type 2 diabetes remission?

According to the Diabetes Canada Guidelines, you’re more likely to be able to put type 2 diabetes into remission if:

  • You were diagnosed with type 2 diabetes relatively recently (less than six years).
  • You are obese or overweight and can lose weight.
  • You do not have an eating disorder or a mental health condition.
  • You have not had diabetes-related complications including heart attack, stroke, kidney disease or eye disease.
  • You are able to work with a type 2 diabetes health-care team.

Your first step? Consult your healthcare provider.

As the guidelines note:

“Remission is a journey, not a destination. It may take a person several turns in the road before they are able to arrive at and maintain remission, and some may never get to remission.

“As such, it is important that the person be supported throughout (and beyond) the remission management approach by a collaborative diabetes care team.”

A diabetes care team may include:

  • A primary care provider (family doctor or nurse practitioner)
  • A dietitian
  • A pharmacist
  • A nurse
  • A physical activity trainer
  • A counsellor
  • An endocrinologist
  • Family and social supports

What are the chances of going into remission?

“We are still learning how to support everyone with type 2 diabetes as they manage their condition,” says Jin. 

“Whether this involves the path of remission or not, I find the best way to support a person in their self-management is to build their capacity for self-care.”

Jin says this includes addressing sleep and stress

She finds it’s also important to support people in their chosen management approach. The goal is to keep your blood sugar levels as close to “non-diabetes” as possible.

Jin says that even if you don’t put your diabetes into remission, managing your blood sugar levels and your weight can bring about many health benefits. This includes reducing the complications and progression of type 2 diabetes.

And if you do go into remission, it’s not a fixed state. It’s possible to go in and out of remission. 

“Some people stay in remission for years,” Jin says.

“Others find that their sugar levels rise again if they regain weight, and they come out of remission. This can happen with the ebbs and flows of life.”

But, as Jin notes: “We believe there may be a cumulative lifetime benefit from any time spent with blood sugar levels below the diabetes range.”

She says that people who can get their sugar levels below the threshold early in their diagnosis, see a protective effect even 20 years out.

How to stay in type 2 diabetes remission

According to Jin, “maintaining weight loss, a healthy diet and being physically active can help you stay in diabetes remission. This helps you manage your blood glucose levels. And it will also benefit your overall health.” 

“It’s important to see your health-care provider regularly. They can help detect if your diabetes symptoms are returning. They can also support you in creating a maintenance plan for your remission.”

How can I get support for the path of remission?

If you’re interested in exploring your options, Jin suggests you reach out to your health-care provider.

“They can work with you to grow your capacity in your health-related goals, including type 2 diabetes remission.”

If your provider doesn’t have information on remission, that’s because it’s still quite new, says Jin. 

You can refer them to: 

Looking for access to a professional support team that will create a tailored plan with you? Learn more about the Diabetes Care Program* for Sun Life members. The Diabetes Care Program is delivered by Lumino HealthTM Pharmacy, provided by Pillway.

*Access to the Diabetes Care Program will be made available to eligible Clients. By participating in the Diabetes Care Program, you agree to the Official Terms and Conditions. Please review the Official Terms and Conditions carefully before participating in the Diabetes Care Program.

This article is meant to provide general information only. It’s not professional medical advice, or a substitute for healthcare professional advice.