The Reversal Revolution: A New Way to Think About Diabetes Care

“When I was diagnosed with diabetes, my world came crashing down. The nurse told me I would have diabetes for the rest of my life, and it felt like a life sentence.” 

That’s from Lester, who was diagnosed with type 2 diabetes in 2012. His experience isn’t uncommon – for decades, we’ve accepted that diabetes is progressive and irreversible. Despite one’s best efforts to make healthy lifestyle changes, more medications are needed and it can feel like that’s the only option. Side effects from these meds often become a part of daily life. Blood sugar continues to climb, and you may become at risk for major complications. You may consider drastic measures like bariatric surgery. But many people just accept that type 2 diabetes will always be a part of their lives.

Move over management. There’s a new way to think about diabetes.

The cost of sticking to the status quo when it comes to diabetes is huge – over $400B in healthcare dollars are spent every year on diabetes in the U.S.1 And the cost to the patient is massive, too – not only the financial burden (4 out of 5 reported that they struggle to afford insulin2), but the toll it takes on their lifestyle. The way we traditionally manage diabetes is ripe for revolution.

Imagine if you could not only stop the progression of diabetes without medication or surgery, but actually reverse it. Meaning – you’d never know someone ever had diabetes by looking at their labs or list of medications. How many lives would it save? How many dollars saved on prescriptions, ER visits, and escalating complications?

But we don’t have to imagine it. The revolution is here, and it’s diabetes reversal.

The reversal revolution gains widespread support

Reversal and remission are gaining widespread support from the scientific community at large, too. In 2021, a group of experts, including representatives from the American Diabetes Association® (ADA), the Endocrine Society, the European Association for the Study of Diabetes (EASD), and Diabetes UK., released a groundbreaking consensus statement officially defining diabetes remission as sustaining normal blood glucose (sugar) levels for three months or more without any diabetes medications. They defined reversal too – as the process of returning blood sugar to pre-diagnostic levels – cementing the term in the lexicon of the broader scientific community.

But it’s not yet crossing over into broader awareness for people who are actually living with type 2 diabetes. Based on a recent survey, only 22% of U.S. adults living with diabetes know that reversal is an option3. It’s crucial that health plans and employers offer the choice of reversal to their populations, and that we continue to educate that the traditional progression of diabetes is not a given.

Making the impossible possible

There are three clinically proven ways to reverse diabetes or put it into long-term remission: 

1.    Bariatric surgery (also known as metabolic surgery): There are several studies that show a wide range of diabetes remission rates. These can be as high as 63%4 at one year and 30%5 at 5 years following surgery. But surgery is invasive, carries risks, and is usually not considered a “first line” option for diabetes.
2.    Very low calorie diet: Medically-supervised low calorie diets can result in remission rates as high as 46%6 at one year. But longer-term, the results are less promising, with one study showing only 7%7 achieving remission at 5 years. 

3.    Very low carbohydrate diet: Very low carbohydrate diets can lead to lower blood sugar, less reliance on diabetes medications, and weight loss. And they can work quickly - sometimes in as little as two weeks8. Results can be sustainable, too, with one study showing that 33% achieved reversal or full remission at 5 years9.

Is long-term reversal realistic?

Studies show that sustained reversal can be realistic, especially using very low carbohydrate therapy. And in this study demonstrating long-term reversal and remission, the intervention was delivered using a relatively new care model – continuous remote care.

People need to make several decisions related to their type 2 diabetes every day. Most traditional management options and even lifestyle interventions geared at reversal or remission don’t take this need for ongoing, sometimes daily support into account. 

That’s why it’s historically been difficult to sustain any improvements or achieve diabetes reversal  – because it wasn’t feasible for PCPs, endocrinologists or diabetes management apps to provide the intensive level of support and interaction with patients that is necessary to drive change. This is changing as technology-enabled virtual care gains momentum. 

Learn more about the reality of reversal

While reversal is gaining steam amongst the scientific community, there is still work to do to educate patients, health plan leaders, providers and benefits leaders. And there are some big questions surrounding reversal: is it safe? Is it really a long-term solution? Why is it possible now?

Download a new report, “The Reality of Reversal - Inside the Revolution in Type 2 Diabetes Treatment” to find out. Plus, learn more about:

●    How technology enables reversal
●    The cost-saving benefits of reversing diabetes
●    How reversal leads to other health benefits


1.    O'Connell JM, Manson SM. Understanding the Economic Costs of Diabetes and Prediabetes and What We May Learn About Reducing the Health and Economic Burden of These Conditions. Diabetes Care. 2019 Sep;42(9):1609-1611. doi: 10.2337/dci19-0017. PMID: 31431494; PMCID: PMC6702611.
2.    Survey sponsored by CharityRx, June 2022. Accessed at:
3.    National Diabetes Reversal Study sponsored by Virta Health . Fielded by dQ&A. Survey conducted from November 30–December 2, 2021 amongst 1,067 Americans with type 2 diabetes.
4.    Robert M, Ferrand-Gaillard C, Disse E, et al. Predictive factors of type 2 diabetes remission 1 year after bariatric surgery: impact of surgical techniques. Obes Surg. 2013 Jun;23(6):770-5. doi: 10.1007/s11695-013-0868-4. PMID: 23355293.
5.    Courcoulas AP, Gallagher JW, Neiberg RH, et al. Bariatric Surgery vs Lifestyle Intervention for Diabetes Treatment: 5-Year Outcomes From a Randomized Trial. J Clin Endocrinol Metab. 2020 Mar 1;105(3):866–76. doi: 10.1210/clinem/dgaa006. PMID: 31917447; PMCID: PMC7032894.
6.    Lean ME, Leslie WS, Barnes AC, et al. Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial. Lancet 2019 May 01.
7.    Gregg EW, Chen H, Wagenknecht LE, et al. Association of an Intensive Lifestyle Intervention With Remission of Type 2 Diabetes. JAMA. 2012;308(23):2489–2496. doi:10.1001/jama.2012.67929
8.    Boden G, Sargrad K, Homko C, et al. Effect of a Low-Carbohydrate Diet on Appetite, Blood Glucose Levels, and Insulin Resistance in Obese Patients with Type 2 Diabetes. Ann Intern Med. 2005.
9.    Volk BM, McKenzie AL, Athinarayanan SJ, et al, A Population Shift in Meeting Glycemic Targets Following Five Years of a Very-Low-Carbohydrate Intervention (VLCI) and Continuous Remote Care (CRC) . Diabetes 1 June 2022; 71 (Supplement_1): 1176–P.

The editorial staff had no role in this post's creation.