According to Diabetes UK, over 4 million people in the UK now live with type 2 diabetes – a 65% increase over the past decade. But there’s some good news: our lifestyle plays a significant role in both developing and managing diabetes. With the right lifestyle changes, it’s possible to put type 2 diabetes into remission – meaning your blood sugar levels return to a non-diabetic range without the need for diabetes medication.
A great example of this is politician Tom Watson. Diagnosed with type 2 diabetes in 2015, he was able to achieve remission through sustained weight loss and lifestyle changes. Thanks to growing research, we now know that this is possible for many people, especially in the early years after diagnosis.
If you’ve been diagnosed with pre-diabetes or type 2 diabetes – or you’re noticing symptoms linked to diabetes – there are meaningful steps you can take to improve your health. In this article, we’ll explore what diabetes is, what remission means, and the lifestyle changes that can support your journey.
What is diabetes?
Diabetes is a condition that causes a person’s blood sugar levels and insulin levels to be too high. The amount of sugar in your blood is controlled by the hormone insulin, which is produced in the pancreas. Insulin moves the glucose (sugar) from the food you have digested into cells where it’s broken down to produce energy.
If your body isn’t producing enough insulin or the insulin your body is producing isn’t working properly then the glucose won’t be turned into energy, leaving you with a high blood sugar level.
Type 1 diabetes is where the body’s immune system attacks and destroys the cells that produce insulin. Type 2 diabetes is where the body doesn’t produce enough insulin, or the body doesn’t react properly to the insulin that’s been produced.
What is pre-diabetes?
Pre-diabetes means that your blood sugar levels are above the normal range but not high enough to be diagnosed as having diabetes. However, you’re at a higher risk of developing Type 2 Diabetes. Unfortunately, pre-diabetes doesn’t have any obvious symptoms. There are several lifestyle changes you can make to reduce the risk of developing type 2 diabetes.
What are the symptoms of type 2 diabetes?
Be aware of the following symptoms:
- Feeling very thirsty
- Increased urination
- Feeling fatigued
- Weight loss
- Blurred vision
- Wounds that aren’t healing
If you’re suffering from any of these symptoms, then you should have a chat with your GP about diabetes.
They may conduct a diabetes test, checking your urine and blood to measure your sugar levels. It can take a couple days to get the results back and, depending on the diagnosis, your GP will explain what happens next. You can book an appointment with your GP using the Evergreen Life app.
What does it mean to put type 2 diabetes into remission?
“Diabetes remission” means bringing your HbA1c levels (a measure of long-term blood sugar) down to below 6.5% (48 mmol/mol) for at least 3 months – without the use of glucose-lowering medications.
This is not a cure – remission means your blood sugars are in a healthy range, but the condition can return. That’s why ongoing monitoring and lifestyle management are still essential.
The good news? Studies now show that losing 10-15 kg (around 1.5-2.5 stone), particularly early after diagnosis, can help many people put type 2 diabetes into remission. This finding comes from the landmark UK-based DiRECT study, which used very low-calorie diets (VLCDs) often described as the ‘soups and shakes’ approach.
The DiRECT study’s 5-year follow-up, published in 2024, showed that those who received ongoing support were more likely to maintain weight loss and stay in remission. Compared to control groups, participants had:
- Greater sustained weight loss
- Higher rates of diabetes remission without medication (27% vs 4%)
- Lower HbA1c levels and fewer diabetes-related complications
- Reduced cardiovascular risks
How achieve type 2 diabetes remission
Achieving remission of Type 2 diabetes is no easy task. It can be a big personal commitment to make significant changes in your lifestyle – after all, a diabetic spends around three hours a year with a healthcare professional, and the other 8,757 hours they must manage their condition themselves, according to Diabetes UK.
But small steps soon build up to big changes, so if you want to take more control of your health to prevent developing diabetes, check out our top tips that you can act on today.
1. Nutrition: A foundation for remission
What and how you eat plays a huge role in blood sugar control and remission potential.
It’s been shown that the total amount of carbs we eat is a predictor of glycaemic response (how much of a sugar rush we get). Even healthy carbs will cause glucose surges, so if you’re at risk of pre-diabetes or diabetes it’s well worth keeping any carbs you eat to those with a low glycaemic index rating and monitor your blood sugar (glucose) levels.
Changing your nutrition habits can be a challenge where fast and cheap food is in abundance on our shelves, but here’s some tips to get you started:
- Watch your carbs: Especially those with a high glycaemic index. They can cause sharp spikes in blood sugar.
- Consider a VLCD (very low carb diet) or low-carb diet: VLCDs have shown strong remission outcomes, while low-carb diets can improve blood sugar control.
- Consider following a keto based diet – studies have shown that the reduction in HbA1c (glucose in our bodies) dropped by as much as 17% when participants followed a keto diet and 94% had insulin decreased or eliminated (under careful medical supervision). So, it’s a good preemptive strike to take by eating more ‘keto’.
- Try intermittent fasting (like 5:2) or portion control: Both have been shown to support weight loss and help lower HbA1c levels.
- Eat a rainbow of 7–10 portions of vegetables and fruit daily. Be mindful of high-sugar fruits.
- Get support: The NHS now offers programmes based on the DiRECT model. Diabetes UK also provides helpful recipes and local support groups.
What’s the best diet for remission? Evidence suggests that the “best” diet is the one you can stick to – long-term adherence and support are more important than the exact plan.
2. Keep on moving
Keeping active helps us lose weight, feel fitter and healthier – and it also helps to reduce our fat stores. Carrying excess fat has been shown to greatly increase your risk of developing type 2 diabetes.Having too much fat around the pancreas and liver can cause insulin resistance, so keeping active and focusing on fat loss rather than weight loss can help reduce the risk of pre-diabetes.
The NHS recommends we do at least 150 minutes of moderate aerobic exercises and two days of strength exercises each week –but if you’re not a regular exerciser that may seem like a lot! Here’s a few ways that can help keep you motivated to move:
- Keep it social – why not join a walking group or an exercise class which can make‘working out’ less of a chore. Why not check out meetup.com for local activities, or if you do need to visit your doctor anytime soon they can also refer you to relevant community groups.
- HIIT it – you don’t have to spend hours on the treadmill to get your heart rate racing. High intensity interval training (HIIT) is a great way of having short, effective workouts that raise the heart and get you burning fat fast.
- Keep it cheap – you don’t have to take out a costly gym membership to do some strength training – there’s lots of body strength exercises you can do at home.If you’re not sure whether working out at home or the gym is best for you, checkout our article on different ways to get fit at home or the gym.
3. Happy heart, happy health
People with diabetes are more at risk of having heart disease, strokes and heart attacks – all things related to our heart health. Keeping active is one thing, but there’s also other lifestyle areas that are worth changing to kkeep your heart healthy and reduce your risk of pre-diabetes.
- Stop the cigs – we’re all aware that smoking is bad for our health, particularly our heart as it can narrow blood vessels, increasing the risk of a heart attack or stroke. There’s plenty of help available from your pharmacist, nurse or GP who can give you advice and refer you to local support groups. There are apps like Quit Buddy that can give you a helping hand when it comes to quitting the ciggies.
- Reduce the booze – Alcohol stops your body from releasing glucose in to the bloodstream causing low blood sugar levels and potentially hypoglycaemia. So, reducing your alcohol intake can reduce the affects of a blood sugar drop.
- Reduce stress – long-term stress can raise blood sugar levels. Read our article on the effects of stress on the body and some tips for helping manage this.
Is diabetes remission really worth the effort?
Yes – without question. Recent studies show that even temporary remission (lasting six months or more) leads to:
- Lower risks of heart attacks and strokes
- Fewer kidney and eye complications
- Reduced all-cause mortality
Even if full remission isn’t achieved or is only short-lived, weight loss still brings substantial health benefits. These include reduced need for medication, lower cardiovascular risk, and potentially fewer cancer cases, according to recent reviews.
Ongoing monitoring after remission is essential
Even in remission, diabetes complications like retinopathy or kidney disease can still develop. That’s why yearly check-ups are vital. Monitoring should include:
- HbA1c testing
- Retinal screening
- Foot exams and blood pressure checks
- Kidney function and weight assessments
Make sure your medical record uses the correct code: “Diabetes in remission” (not “diabetes resolved”). This keeps you in the system for ongoing screening and support. You can check this by linking your Evergreen Life app with your GP and viewing your GP record.
Final thoughts: You have more control than you think
Type 2 diabetes doesn’t have to be a life sentence. With lifestyle changes, education, and support, remission is possible. Even if you don’t achieve full remission, improving your diet, increasing your activity levels, and losing weight can dramatically improve your overall health and reduce your risk of serious complications.
There are tons of great resources that can help you manage your health. You could use the Evergreen Life app to keep track of your health and wellbeing and feel more in control of your own health information, you can download it for free. And remember, you’re not alone – your GP, diabetes teams, and community resources are here to help.
Change the conversation from “You have a progressive condition” to “You have the power to take control of your health – and maybe even put your diabetes into remission.”
- Cheng-Chieh Lin, Chia-Ing Li, Chiu-Shong Liu, Wen-Yuan Lin, Martin Mao-Tsu Fuh, Sing-Yu Yang, Cheng-Chun Lee, Tsai-Chung Li; Impact of Lifestyle-Related Factors on All-Cause and Cause-Specific Mortality in Patients With Type 2 Diabetes: The Taichung Diabetes Study. Diabetes Care 1 January 2012; 35 (1): 105-112.
- Dambha-Miller H, Hounkpatin HO, Stuart B, Farmer A, Griffin S (2023) Type 2 diabetes remission trajectories and variation in risk of diabetes complications: A population-based cohort study. PLOS ONE 18(8): e0290791.
- Hallberg SJ, McKenzie AL, Williams PT, Bhanpuri NH, Peters AL, Campbell WW, Hazbun TL, Volk BM, McCarter JP, Phinney SD, Volek JS. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther. 2018 Apr;9(2):583-612. doi: 10.1007/s13300-018-0373-9. Epub 2018 Feb 7. Erratum in: Diabetes Ther. 2018 Apr;9(2):613-621. doi: 10.1007/s13300-018-0386-4. PMID: 29417495; PMCID: PMC6104272.
- Hallberg, S.J., McKenzie, A.L., Williams, P.T. et al. Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study. Diabetes Ther 9, 583–612 (2018).
- Lean, Michael EJ et al., 5-year follow-up of the randomised Diabetes Remission Clinical Trial (DiRECT) of continued support for weight loss maintenance in the UK: an extension study. The Lancet Diabetes & Endocrinology, Volume 12, Issue 4, 233 – 246.
- Matthew C. Riddle, William T. Cefalu, Philip H. Evans, Hertzel C. Gerstein, Michael A. Nauck, William K. Oh, Amy E. Rothberg, Carel W. le Roux, Francesco Rubino, Philip Schauer, Roy Taylor, Douglas Twenefour; Consensus Report: Definition and Interpretation of Remission in Type 2 Diabetes. Diabetes Care 1 October 2021; 44 (10): 2438–2444.
- McKenzie A, Hallberg S, Creighton B, Volk B, Link T, Abner M, Glon R, McCarter J, Volek J, Phinney S, A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes, JMIR Diabetes, 2017;2(1):e5.
- Saul H, Deeney B, Swaithes L, Hounkpatin H, Dambha-Miller H. Even short periods of diabetes remission are linked to lower risk of heart attack and stroke BMJ 2024; 384 :q516 doi:10.1136/bmj.q516.
- Taylor R, Ramachandran A, Yancy W S, Forouhi N G. Nutritional basis of type 2 diabetes remission BMJ 2021; 374 :n1449 doi:10.1136/bmj.n1449.
- Taylor R, Very low calorie diets and total diet replacement in type 2 diabetes: where are we now? Drug and Therapeutics Bulletin 2024;62:39-42.
