Can a Plant-Based Diet Reverse Type 2 Diabetes?

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Diabetes is a leading cause of death worldwide with an estimated 1.5 million deaths each year directly attributable to diabetes, primarily type 2 diabetes. And the disease is a major cause of other health complications—kidney failure, heart attacks, strokes, and lower limb amputations. Along with those conditions goes rising healthcare costs. For example, in the United States, diabetes makes the list for the top five medical conditions accounting for a third of all medical expenditures, and spending more than doubled over 20 years. Diabetes is the only disease for which cost per person has increased significantly for these top five medical conditions, coming in close to $3,400 per person. The majority of those costs come from prescription medications. And while diabetes medications can be a very important tool for controlling blood glucose levels, what if there were another way?

Could a plant-based diet be the solution, not only to diabetes prevention but to type 2 diabetes treatment? And not just any treatment, but actually with the goal of diabetes remission! The American College of Lifestyle Medicine convened a group of experts including representatives from major groups like the American College of Cardiology, the American Heart Association, the Academy of Nutrition and Dietetics … the list goes on … who reviewed the available evidence on dietary interventions for type 2 diabetes treatment for remission, and reached agreement on three key issues. First, type 2 diabetes remission should be defined as having HbA1c, a marker of blood glucose control, below 6.5 percent for at least three months with no surgery, devices, or active drug therapy being used to lower blood sugars; second, diet as a primary intervention for type 2 diabetes can achieve remission in many adults and is related to the intensity of the intervention; and finally, the big one … diet as a primary intervention is the most effective in achieving remission when emphasizing whole, plant-based foods with minimal consumption of animal products.

Why is this so profound? In addition to experts from all these different groups agreeing, nutrition therapy is not usually discussed in the context of remission, but rather as an add-on to go with whatever drugs are prescribed for blood sugar control, or as a way to help delay or prevent complications. In this consensus statement, remission was endorsed as the clinical goal for type 2 diabetes, and it is most optimally attained using a whole-food, plant-based diet that emphasizes unrefined plant foods and eliminates or minimizes animal foods and refined foods, and of course, includes moderate exercise that we all should be getting on a regular basis.

Oh, and critically, the intervention meant to help with type 2 diabetes shouldn’t cause adverse health effects itself, such as very low-carb ketogenic diets, which might appear to help with blood glucose control, but in fact produce negative cardiometabolic side effects.

Here’s what can happen after treatment with a high-fiber, low-fat, plant-predominant diet. The authors wanted to show the feasibility of medication reduction and type 2 diabetes remission using a lifestyle-based intervention without drastically cutting calories. Patients with diabetes were referred to a wellness clinic, and received information on adopting a plant-predominant diet along with addressing other major risk factors. Importantly, these patients didn’t self-select into a specific lifestyle medicine treatment program. They were simply presented with lifestyle prescriptions as part of their routine medical care. What a wild idea! Here’s a visual of the plant-predominant diet they were encouraged to follow—about 95 percent plants, with a lot of veggies, beans, whole grains, fruits, and seeds.

The researchers took a closer look at those patients who had adopted the recommended plant-centric diet and successfully decreased their blood sugar to non-diabetic ranges. How many people experienced remission? More than a third of them, and almost half with HbA1c levels below 6.5 percent, were able to discontinue all medications—they just hadn’t yet reached the three consecutive months of testing required to get the label for “official remission.” A lifestyle-based intervention, primarily focused on education about the benefits of a plant-predominant diet for diabetes treatment and remission, resulted in decreased blood glucose markers to levels achieving both reduction of medications and remission of type 2 diabetes, highlighting the promising potential for a plant-predominant diet to confer immediate and long-term benefit including reducing complications of type 2 diabetes.

Please consider volunteering to help out on the site.

• Del Carmen Fernández-Fígares Jiménez M. Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence. Nutr Rev. 2024;82(7):929-948.
• Biener AI, Decker SL, Rohde F. Source of increased health care spending in the United States. JAMA. 2019;321(12):1147.
• Schlesinger S. Diet and diabetes prevention: is a plant-based diet the solution? Diabetes Care. 2023;46(1):6-8.
• Rosenfeld RM, Kelly JH, Agarwal M, et al. Dietary interventions to treat type 2 diabetes in adults with a goal of remission: an expert consensus statement from the american college of lifestyle medicine. Am J Lifestyle Med. 2022;16(3):342-362.
• Panigrahi G, Goodwin SM, Staffier KL, Karlsen M. Remission of type 2 diabetes after treatment with a high-fiber, low-fat, plant-predominant diet intervention: a case series. Am J Lifestyle Med. 2023;17(6):839-846.

Motion graphics by Avo Media

• beans
• blood sugar
• diabetes
• exercise
• fruit
• grains
• kidney failure
• Plant-Based Diets
• seeds
• stroke
• vegetables