Type 2 diabetes is one of the most significant health challenges facing Australians today. Affecting over 1.3 million Australians, this chronic condition is on the rise, with an estimated 280 Australians developing diabetes every day—that’s one new diagnosis every five minutes.
Additionally, around 2 million Australians are at high risk of developing the condition in the near future. Often viewed as a lifelong, progressive disease that requires ongoing medication and strict management, many people don’t realise that some people with type 2 diabetes can achieve remission. Through my work in functional medicine, I’ve worked with patients who have achieved remission, and many more who have significantly improved their metabolic health without reaching it, allowing them to live healthier and more fulfilling lives.
As a functional medicine doctor, my approach to type 2 diabetes goes beyond simply managing blood sugar levels. By focusing on the root causes of insulin resistance, inflammation, and poor metabolic health, I aim to address the core factors driving the disease. With a personalised, holistic approach, I’ve helped patients regain control over their health. In some cases, and always under medical supervision, this has allowed a treating doctor to review and adjust medication.
The Nature of Type 2 Diabetes
To understand how we can reverse type 2 diabetes, we first need to understand what it is. Type 2 diabetes occurs when the body becomes resistant to insulin or fails to produce enough insulin to regulate blood sugar levels effectively. Insulin is a hormone that allows glucose (sugar) from the food we eat to enter cells, where it’s used for energy. When insulin isn’t working properly, glucose builds up in the blood, leading to high blood sugar levels.
Over time, consistently high blood sugar can cause serious complications, including heart disease, nerve damage, kidney disease, and vision problems. The economic toll of managing diabetes is enormous, with Diabetes Australia warning that the number of people living with diabetes could climb to more than 3.1 million by 2050, resulting in 2.5 million hospitalisations per year and costing Australia around $45 billion per annum. Type 2 diabetes is often treated with medications such as insulin or oral drugs that help manage blood sugar levels. However, these treatments don’t address the underlying causes of the disease and often result in a cycle of increasing medications without actually improving the patient’s long-term health.
A Functional Medicine Perspective
Functional medicine offers a different approach. Instead of focusing on the symptoms of diabetes, such as high blood sugar, functional medicine looks at the whole person, seeking to understand the underlying imbalances that contribute to the disease.
This involves considering factors such as:
- diet
- lifestyle
- gut health
- inflammation
- and stress
All of which play a role in insulin resistance and metabolic dysfunction.
The goal of functional medicine is to restore the body’s natural balance, improve insulin sensitivity and, for some people, work towards remission under medical supervision. This is attempted through a combination of personalised nutrition, lifestyle changes, and targeted therapies aimed at addressing the root causes of the disease.
Insulin Resistance: The Key to Remission
At the heart of type 2 diabetes is insulin resistance. Insulin resistance occurs when the body’s cells become less responsive to the hormone insulin, making it harder for glucose to enter the cells. This leads to high blood sugar levels and forces the pancreas to produce more insulin in an attempt to compensate. Over time, the pancreas becomes overworked, and insulin production declines, leading to worsening blood sugar control.
One of the most effective ways to reverse type 2 diabetes is to improve insulin sensitivity. By making the body’s cells more responsive to insulin, we can help lower blood sugar levels and reduce the strain on the pancreas. There are several key strategies for improving insulin sensitivity, many of which are central to the functional medicine approach.
Personalised Nutrition: The Foundation of Remission
One of the most powerful tools in reversing type 2 diabetes is nutrition. The standard dietary advice for diabetes—focusing on low-fat, high-carbohydrate foods—has not been successful for many people. Instead, emerging research shows that diets lower in carbohydrates and higher in healthy fats can have a significant impact on blood sugar control and insulin sensitivity.
I work with each patient to develop a personalised nutrition plan that meets their specific needs. For many, this involves adopting a low-carbohydrate or ketogenic diet, which helps to reduce blood sugar spikes and improve insulin sensitivity. In some cases, intermittent fasting can also be an effective strategy for improving metabolic health and supporting weight loss.
Why Low-Carb Diets Work
There is reasonable evidence that, for some people, reducing carbohydrate intake helps. By reducing the amount of sugar and starches in the diet, we reduce the body’s need for insulin. This helps to stabilise blood sugar levels and prevent the large spikes and crashes that are common in people with diabetes. Over time, a low-carb diet can help to “reset” the body’s insulin response, making the cells more sensitive to insulin and improving overall metabolic health.
In fact, studies have shown that low-carbohydrate diets can lead to significant improvements in blood sugar control and may even allow some people to reduce or stop their diabetes medication. One study, The 2018 DiRECT study published in The Lancet, found that 46% of participants with type 2 diabetes were able to reverse their condition after following a low-carbohydrate diet for a year. Another study, published in Diabetes Care, showed that a very low-carbohydrate diet led to greater reductions in blood sugar levels and medication use compared to a low-fat diet.
Gut Health and Inflammation: The Hidden Drivers of Diabetes
In functional medicine, we recognise that the health of the gut plays a crucial role in overall well-being, and this is especially true when it comes to diabetes. Chronic inflammation is a key factor in the development of insulin resistance, and it’s theorised much of this inflammation originates in the gut.
The gut is home to trillions of bacteria, fungi and viruses, known as the microbiome, which play a vital role in regulating inflammation, immune function, and metabolism. When the balance of these bacteria is disrupted—through poor diet, stress, or medication use—it can lead to a condition known as “leaky gut,” (increased intestinal permeability) where the lining of the intestines becomes more permeable. This allows harmful substances to enter the bloodstream, like LPS toxins, triggering inflammation throughout the body.
The microbiome also has a role in digestion, and therefore the regulation of blood sugar, and provides a significant percentage of the small molecules in the blood that cells need to be healthy.
By improving gut health through diet, probiotics, and targeted supplements, we may be able to help reduce inflammation and support better blood glucose control. This is why I often incorporate gut-healing protocols into my treatment plans for patients with type 2 diabetes.
Managing Stress and Mental Health: A Key Component of Remission
Stress is another major contributor to insulin resistance and poor metabolic health. When we’re stressed, the body releases the hormone cortisol, which raises blood sugar levels and promotes the storage of fat, particularly around the abdomen. Chronic stress can lead to persistent high cortisol levels, which in turn worsen insulin resistance and make it more difficult to control blood sugar.
As part of a functional medicine approach to diabetes reversal, it’s essential to address stress and support mental health. This might include mindfulness practices, meditation, counselling, and other strategies to help reduce stress and improve emotional well-being. In my practice, I often work with patients to develop personalised stress management plans, which can have a profound impact on both their mental and physical health.
Exercise and Movement: Supporting Insulin Sensitivity
Exercise is another important tool in reversing type 2 diabetes. Regular physical activity helps to improve insulin sensitivity by making the muscles more efficient at using glucose for energy. Even moderate exercise, such as walking or cycling, can have a significant impact on blood sugar control and overall metabolic health.
In functional medicine, we emphasise the importance of movement throughout the day, rather than focusing solely on structured exercise sessions. This might include simple changes such as taking regular breaks to stand and stretch, walking after meals, or incorporating more activity into daily routines.
For patients with type 2 diabetes, I recommend a combination of aerobic exercise (such as walking or swimming) and resistance training (such as weight lifting or bodyweight exercises), which has been shown to be particularly effective in improving insulin sensitivity and supporting weight loss.
Authored by Dr Chris Chappel
Dr Chris Chappel is a very experienced and specialised Functional Medicine GP with special interests in type 2 diabetes remission and metabolic health, weight management, mental health and gut health. He also assists individuals who are currently in good health in optimising their well-being, maximising their performance, and take a preventive approach to their long-term health through comprehensive health checks and health coaching.
Book an appointment with Chris
References:
- AIHW Diabetes Report: https://www.aihw.gov.au/reports/diabetes/diabetes/contents/summary
- Diabetes Australia 2023 Report: https://www.diabetesaustralia.com.au/wp-content/uploads/2023-Snapshot-Diabetes-in-Australia.pdf
- https://www.diabetesaustralia.com.au/mediarelease/dramatic-jump-in-diabetes-costs/
- A study on low-carbohydrate diets and their impact on metabolic health. Read more at Diabetes Journals.
- https://www.diabetes.co.uk/
- https://diabetesjournals.org/care/article/37/11/2909/29068/A-Very-Low-Carbohydrate-Low-Saturated-Fat-Diet-for
This article is general information only and is not medical advice. It does not take your personal circumstances into account and is not a substitute for consultation with your GP or diabetes healthcare team. Individual results vary; the outcomes described are not typical and are not guaranteed.
