A Choice: Living With Diabetes, Seeking Remission From Diabetes

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Note: This article was originally posted on February 3, 2021, and was updated on July 13, 2026.

Is The Only Choice to Accept a Type 2 Diabetes Diagnosis?

No. When people get diagnosed with type 2 diabetes, they have a choice to “live with it” or to seek remission from its symptoms.  Complete remission (no longer meeting the criteria for diagnosis) and partial remission (no longer meeting some of the criteria) are both possible, and have been documented through dietary and lifestyle changes, including a very low-calorie diet and a very low-carbohydrate (ketogenic) diet.

The question is, do people want to live with the disease, or seek remission from its symptoms?  

What are the Criteria for Diabetes Remission?

The American Diabetes Association, as explained in this earlier article, has defined partial remission, complete remission, and prolonged remission from type 2 diabetes, as outlined here.

  • Partial remission is having blood sugar that does not meet the classification for Type 2 Diabetes; i.e., either HbA1C < 6.5% and/or fasting blood glucose 5.5 — 6.9 mmol/l (100—125 mg/dl) for at least 1 year while not taking any medications to lower blood glucose.*

* Some studies, such as those from Virta Health, define partial remission as an HbA1C < 6.5% and fasting blood glucose ≤ 5.5 (100 mg/dl) while taking no medication, or only generic Metformin.

  • Complete remission is a return to normal glucose values, i.e., HbA1C <6.0%, and/or fasting blood glucose < 5.6 mmol/L (100 mg/dl) for at least 1 year while not taking any medications to lower blood glucose.
  • Prolonged remission is a return to normal glucose values (i.e., HbA1C <6.0%, and/or fasting blood glucose < 5.6 mmol/L (100 mg/dl) for at least 5 years while not taking any medications to lower blood glucose.

Complete and prolonged remission are achievable with bariatric surgery, such as the Roux-en-Y procedure, and the use of GLP-1 medications, but many people are unaware that both complete remission and partial remission are available options by making dietary and lifestyle changes, including a very low-calorie diet and a very low-carbohydrate (ketogenic) diet.

There is also some long-term data of 5 years or more documenting prolonged remission with dietary and lifestyle changes alone.

 

Supporting Individual Choice

I believe that the only change that will be sustainable for a person comes from inside of themselves (see Stages of Change), and I support people with a range of goals when it comes to type 2 diabetes, 

  • Some people come to me with a diagnosis of pre-diabetes, wanting to implement dietary changes to avoid getting type 2 diabetes.
  • Others come to me once they are diagnosed with type 2 diabetes, wanting to control their blood sugar level through dietary changes and avoid complications.
  • More and more people come to me after diagnosis to have me help them put the symptoms of type 2 diabetes into remission.

Each is a valid goal.

That said,

    • Some people who know that it is possible to put the symptoms of type 2 diabetes into remission find it difficult to understand why not everyone would want to put theirs into remission.
    • Some people don’t know that remission of type 2 diabetes is possible, believing that type 2 diabetes is automatically both chronic (long-term) and progressive (getting worse with time). These beliefs enable me to explain that type 2 diabetes can be put into remission, and the different ways that I can support them in aiming to achieve that.
       
    • Other people may simply want to ‘manage’ their blood sugar levels to keep them from getting higher to avoid complications. They don’t want to have normal blood sugar, but just want to minimize erectile dysfunction, avoid losing toes, or going blind. I make sure that they know that it is possible to achieve remission (because many don’t know), and if they don’t want to make the significant lifestyle changes required to do that, then I will help them manage their diet to keep their blood sugar from getting higher. 

I believe that understanding the options, that each person has the right to choose the goals that suit them best, and to be supported by their healthcare team, including me, in meeting them. 

 

Clinical Application

Since type 2 diabetes is really “end-stage carbohydrate intolerance“, the amount and type of carbohydrate that is on the Meal Plans I design reflect an individual’s goals. After all, it is their Meal Plan, not mine.

Those who choose to live with diabetes have just as much right to dietary support to meet those goals as someone who desires to seek remission from diabetes, and people are also at different stages of change when it comes to having type 2 diabetes. Some may want to start by managing their symptoms, and only later arrive at a point where they want to seek remission. If, and when they do, I will support them in doing that. 

More Info

If you have been diagnosed with type 2 diabetes and would like dietary support, I would be glad to help. You can view my Comprehensive Dietary Package here and learn about me.

To your good health!

Joy

You can follow me on:

Twitter: https://twitter.com/jyerdile
Facebook: https://www.facebook.com/BetterByDesignNutrition/

 

Quick Clinical Summary

Q: What is the difference between diabetes management and remission?

A: Management focuses on controlling blood sugar levels to prevent complications like neuropathy or vision loss, often through medication and moderate dietary changes. Remission is achieved when blood sugar levels return to below the diabetic range (HbA1c < 6.5%) for a sustained period without glucose-lowering medications.

Q: How does the ADA define ‘Complete Remission’ of Type 2 Diabetes?

A: Complete remission is defined as a return to normal glucose values, specifically an HbA1c < 6.0% and/or fasting blood glucose < 5.6 mmol/L (100 mg/dl), maintained for at least one year without the use of any glucose-lowering medications.

Q: Is type 2 diabetes remission possible without weight-loss surgery?

A: Yes. Clinical evidence demonstrates that partial and complete remission can be achieved through dietary and lifestyle interventions, such as very low-carbohydrate (ketogenic) diets or very low-calorie diets that address insulin resistance and carbohydrate intolerance.

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