Can Type 2 Diabetes Be Reversed After 20 Years? What Nobody Tells the People Who've Had It the Longest

"Can type 2 diabetes be reversed, or is that just for the young ones?" Dolores typed that into her phone in the hospital parking garage in August, after her husband Earl's endocrinologist added a third medicine. Earl is 72, a retired school bus mechanic from Joplin, Missouri, and he has had type 2 diabetes for twenty-three years. Every few years, he says, the pill list gets longer and the conversation gets shorter.

If you've had it for fifteen, twenty, thirty years, you have probably seen the headlines about "reversing" diabetes and felt something close to insult. The success stories always seem to be a 48-year-old who caught it early and cut out bread. You did all of that. Years ago.

Does this sound like you?

• You were diagnosed in the 1990s or 2000s and have been on metformin most of that time
• A second medicine was added, then a third, or a weekly shot, or insulin
• Your A1c creeps up a little at nearly every visit, even when you're careful
• You've stopped asking your doctor about remission because you assume you're too far along
• Your family has quietly started treating your diabetes as permanent, and so have you

If two or more of those fit, keep reading. The honest answer to your question is more interesting than "no."

What the remission research actually says about time

The best-known remission studies of the last decade used very low-calorie meal plans and closely supervised weight loss. In the most cited one, run in Scotland and England, close to half the people in the program were off their diabetes medicines with normal-range numbers after a year. That is a real result, and it changed how doctors talk about type 2.

But read the fine print. Those volunteers had been diagnosed within the previous six years. And across that research, the same pattern keeps showing up: the shorter the time since diagnosis, the better the odds. Researchers think the reason is the pancreas. Early on, the cells that make insulin are tired but still there. After many years of overwork, more of them have worn down, and losing weight alone often can't bring them back.

The question for someone like Earl isn't "did I eat right." It's "what has twenty-three years done to the part of me that makes insulin, and is anyone looking at it?"

That is exactly the question most appointments skip. The visit is about the number. The pill list is about the number. Very little of the standard plan is about why the number keeps rising in someone who has been doing everything right for two decades.

What Earl had already done

• Metformin, since 2003. It helped for years, as it does for most people. Then it helped less.
• The second pill, then the third. Each one brought the number down for a season. Each season was shorter.
• Diet, more than once. He gave up sweet tea in 2009 and white bread in 2014. Dolores weighs his potatoes.
• Walking after supper. Every night, around the block twice, unless it's icing.

Every one of those can help, and none of them is a mistake. But all of them work on what happens after the food goes in. Not one of them was aimed at what twenty-three years had done to the pancreas itself.

The presentation Dolores found

A woman from Dolores's Tuesday quilting circle, whose husband has had diabetes nearly as long as Earl, sent her a long video in September. It follows a researcher trained at a top university who spent years working inside the drug industry before she walked away, and who started over after watching a family member keep losing ground on every new prescription.

Her view goes somewhere most appointments never go. She believes something settles in the gut, travels to the pancreas and slowly wears down the cells insulin depends on, and that the longer it stays, the more ground it takes. In her telling, that's why years on the calendar matter so much, and why people who've had diabetes the longest are often the slowest to respond to anything. It's also why she built her approach around the long-timers first instead of leaving them for last.

That is her view, and MetabolicDaily has not verified it. What she uses against it, what she found in a very old text that sent her looking, and why she changed her formula after watching who responded slowest are things she explains in her own words. We aren't going to give them away. If you've carried this for twenty years, you've earned the full explanation.

Earl, after the kitchen-table viewing

Earl did not want to watch it. "Twenty-three years, I've seen every miracle there is," he said. Dolores watched it alone that night, then put it on the big TV the next morning with his coffee. He made it about ten minutes before he put the coffee down.

"It was the part about the old-timers responding slowest," he said. "That's me. Nobody had ever said that part out loud. They just keep handing me a new pill like I'm the same as some fella who found out last spring."

He took what he learned to his doctor before changing anything, which is exactly what the presentation tells people to do, and he still takes every medicine on his list.

What Earl noticed, and how long it took

• Week 1. Nothing. Dolores started writing his bedtime readings on the calendar by the phone.
• Weeks 2 and 3. A few readings lower than either of them expected. Not every day. She circled those.
• Month 1. More circles than blank days. He stopped falling asleep in his chair after lunch, which Dolores noticed before he did.
• Months 2 and 3. His fall lab work came back moving the right direction for the first time since the second pill was added. His doctor didn't say "reversed." He said, "Let's keep doing whatever you're doing." Earl asked Dolores to write it down.

Why so slow, and why so modest? Because A1c reflects about three months of blood, and because someone who has had diabetes for twenty-three years should expect the slowest response of anyone, not the fastest. Earl and Dolores agreed before they started to give it a full season and judge it by the lab sheet. Individual results vary, and nothing here replaces the medicine your doctor prescribed.

Before you watch: who this is for

It may be for you if you've had type 2 for many years, your A1c keeps drifting up despite doing what you were told, and you've quietly assumed you're too far along for anything to change. It's also for the spouse or grown child who keeps the calendar by the phone.

It is not a reason to stop or change your medication. If you take insulin or anything that lowers blood sugar, talk to your doctor before adding anything new, and keep checking your readings, since your numbers can move. If you're pregnant or nursing, have kidney or liver problems, or your readings run very high with heavy thirst or blurry vision, call your doctor first.

Give it the full length. It runs long because she shows her work. Watch it with whoever sits across from you at supper, then decide together.

P.S. Dolores still has the search in her phone from the parking garage: can type 2 diabetes be reversed. She says the answer she got was better than yes or no. It was "nobody has been looking at the right thing." If you're sitting in that same garage after another new prescription, start with the video she started with.

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