"Reversed" is a marketing word. The clinical term is remission: an HbA1c under 6.5% for at least three months without diabetes medication.
The two strongest approaches
### Very-low-calorie diets (DiRECT trial) The UK DiRECT trial put participants on 800 kcal/day shakes for 12–20 weeks. 46% achieved remission at one year; 36% sustained it at two years. The strongest predictor was total weight loss — 15 kg or more gave the best odds.
### Low-carb diets (Virta Health) Long-term low-carb eating (under 50g net carbs/day) drove 54% of participants into remission after one year, with sustained results at two and five years.
Who has the best chance?
- Recent diagnosis (under 6 years)
- Lower baseline HbA1c
- Higher residual insulin production
- Willingness to lose meaningful weight
What remission isn't
It doesn't mean cured. If you regain weight or return to high-carb eating, blood sugar usually climbs back. Think of it as managed — like high blood pressure that stays in range only while you keep the habit.
Always coordinate diet changes with your doctor, especially if you take insulin or sulfonylureas — sudden carb reduction can cause dangerous hypos without dose adjustment.