Type 2 diabetes can’t be cured or fully reversed, but it can go into remission for some people. Remission means HbA1c stays below 6.5% (48 mmol/mol) for at least three months without glucose-lowering medicines. It may not last: blood glucose can rise again, so regular HbA1c checks are still needed.
Many people search for “reversing” diabetes, but the RACGP’s diabetes handbook is clear that remission doesn’t mean type 2 diabetes is cured or reversed. Some people stop their diabetes tablets after major changes to weight, eating and activity. Below: what remission means, what affects your chances, what an Australian trial found, and what needs to happen afterwards.
What Is Diabetes Remission?
Remission is not a cure. Your blood glucose has returned to the non-diabetes range without glucose-lowering medicines, but the underlying glucose intolerance can continue, heart disease risk can stay higher, and glucose levels can climb again over time. If your HbA1c rises back into the diabetes range, remission has ended.
To count as remission, your HbA1c (a measure of your average blood glucose over the past two to three months) needs to stay below 6.5% (48 mmol/mol) for at least three months while you’re off glucose-lowering medicines. Our guide to blood sugar levels and tests explains HbA1c in more detail. For how type 2 diabetes works and how it differs from type 1, see the difference between type 1 and type 2 diabetes.
Still, remission can make a real difference. Some people manage without glucose-lowering medicines, and some stay in remission for years with ongoing changes to weight, eating and activity.
What Helps People Reach Remission?
There is no single method that guarantees remission. Type 2 diabetes, also known as late-onset diabetes, develops when the body becomes less responsive to insulin, and over time the pancreas may struggle to keep up.
Remission means having an HbA1c (your average blood sugar level over the past 2–3 months) below 6.5% (48 mmol/mol) for at least three months without taking glucose-lowering medication.
For some people, losing a substantial amount of weight can help improve blood glucose control and lead to remission. The RACGP recommends intensive lifestyle changes for appropriate patients, while low-calorie meal-replacement programs may also be considered under clinical supervision.
Weight loss
Weight loss can change the way the body handles glucose and insulin. Research suggests that people with obesity may need to lose around 10–15% of their body weight to have a reasonable chance of achieving remission.
But that figure shouldn’t be considered a guarantee. People respond differently, and the likelihood of remission also depends on other factors, such as how long they have had diabetes, their HbA1c, and whether they use insulin.
Physical activity
Weight loss is not the only lifestyle factor that matters. Regular physical activity helps the body use insulin more effectively and can support blood glucose management, and our guide to how exercise helps manage diabetes covers how to start safely.
Eating habits
Food selection is also important, especially when it supports sustained weight loss. The real difficulty is finding a method that works for the person in their daily routine, not just for a few weeks with a very restrictive diet.
Other medical options
Some adults discuss bariatric surgery (generally for a body mass index of 35 or above) or weight-loss medicines with their doctor. Your GP can talk through whether either is suitable, and can arrange a specialist referral or a weight loss consultation.
Starting earlier can matter
It is more likely that late-onset diabetes will remit if the diabetes diagnosis is recent. The RACGP considers that shorter diabetes duration, a lower HbA1c at the time of attempting remission, and not requiring insulin are among the factors that increase the likelihood of remission.
This doesn’t mean it won’t happen after years of late-onset diabetes, though. It means that the risk may increase when the condition progresses.
Can Weight Loss Lead to Type 2 Diabetes Remission?
There isn’t a set amount of weight loss that guarantees remission, but the DiRECT-Aus study shows how remission rates varied with the amount of weight participants lost.
At 12 months, the remission rates for participants were:
- 87% — more than 15% weight loss
- 75% — 10–15% weight loss
- 45% — 5–10% weight loss
- 38% — 5% or less weight loss
The study followed 155 adults aged 20–65 who had type 2 diabetes for up to six years, a BMI above 27, and no insulin use. Participants began with a low-energy Total Diet Replacement (TDR) phase, followed by gradual food reintroduction and support to maintain weight loss. At 12 months, 86 participants (56%) were in remission (55% using the three-month definition above), with an average weight loss of 8.1%. Remission was highest, at 66%, straight after the diet-replacement phase.
The link between weight loss and remission was clear but not absolute: 38% of people who lost 5% or less were also in remission. There was no comparison group, and everyone had regular dietitian support, so results from a supported program won’t necessarily match what happens on your own.
How Does Total Diet Replacement Work?
Total Diet Replacement (TDR) means replacing your usual meals with specially made shakes, soups or other meal-replacement products for a short period. In the DiRECT-Aus study, this phase lasted 13 weeks, followed by 8 weeks of reintroducing regular food, then ongoing support through the rest of the year.
TDR isn’t a crash diet. Cutting calories significantly can lower blood glucose levels and may require adjusting diabetes medication. That’s why it should be done under a healthcare professional’s guidance.
The DiRECT-Aus results are encouraging, but they don’t mean that everyone with this type will have the same results. The people in the study met certain requirements and had regular support throughout the program.
Eating this little can bring blood glucose down quickly, so diabetes medicines often need adjusting, and blood pressure medicines may too. In DiRECT-Aus, two participants were hospitalised with low blood pressure related to the program. That’s why TDR needs supervision from a GP or dietitian, not a start on your own. The results are encouraging, but they don’t mean everyone will do as well.
What Happens After Remission?
Post-remission monitoring for diabetes should be continued. The RACGP recommends frequent monitoring of HbA1c levels after reaching remission, at least once every 6 months, to determine whether remission is ongoing or diabetes has returned.
Continuing care may involve continuing monitoring:
- Blood pressure
- Cholesterol and cardiovascular risk
- Weight
- Blood glucose
- Other diabetes-related health measures
How long does remission last?
Not always long. The RACGP says that fewer than half of the people who attempt remission through intensive dietary change reach it at one year, and only about a third are still in remission after two years. In the UK DiRECT trial, 46% were in remission at one year and 36% at two. In DiRECT-Aus, remission fell from 66% straight after the diet-replacement phase to 56% at 12 months.
Can You Stop Taking Diabetes Medication?
If your blood glucose readings are in the healthy range, don’t stop or reduce your diabetes medication without first speaking to your GP or diabetes healthcare team. Your levels may be in range because the medication is working.
If you have lost a significant amount of weight or think you may be in remission, your doctor can review your HbA1c, blood glucose levels and treatment before deciding whether your medication needs to be changed.
Some medicines are also worth keeping for reasons beyond blood glucose. The RACGP notes that SGLT2 inhibitors and GLP-1 receptor agonists have heart and kidney benefits, so your doctor may recommend continuing them even when your glucose is in the normal range.
When Should You Speak With a GP?
Consider speaking with a GP if you:
- Have been recently diagnosed
- Are concerned about changes in your blood glucose levels
- Have had a significant or unexplained change in weight
- Are experiencing symptoms that concern you
- Need an HbA1c test or other diabetes-related testing
- Are unsure whether you need further treatment or a referral
HelloGP offers online GP consultations across Australia. A GP can review your medical history and test results, discuss your concerns and arrange testing or referral if needed. You can book an online GP consultation for your diabetes care, and your GP can provide a pathology referral for an HbA1c test where appropriate.
Getting Started: Your Path to Remission
If you’re thinking about remission, there are a few things worth discussing with your healthcare team. Your chances and the safest approach can depend on how long you’ve had late-onset diabetes,, your current HbA1c and the treatment you’re using.
Some things to consider include:
- How long you’ve had diabetes: remission may be more achievable earlier in the condition
- Your current HbA1c: your starting blood glucose levels can affect what may be possible
- Your treatment history: your current and previous diabetes treatment matters
- Whether weight loss is appropriate: not everyone needs to lose weight
- What you can maintain long term: any changes need to fit your health and circumstances
There is no single path to remission. The aim is to find an approach that is safe, realistic and suited to you.
Frequently Asked Questions (FAQ)
Can type 2 diabetes go away?
Type 2 diabetes can go into remission for some people. This means having an HbA1c below 6.5% (48 mmol/mol) for at least three months without glucose-lowering medication. Remission does not mean the condition has been permanently cured.
Remission is most often linked to significant weight loss, particularly in the first few years after diagnosis, and bariatric surgery can also lead to it. Not everyone achieves remission, and it isn’t a measure of effort, as genetics, age and how long you’ve had diabetes all play a part. Blood glucose can rise again, so regular HbA1c checks and screening for the eyes, feet and kidneys still matter.
Never stop or reduce diabetes medication without medical advice, as this can cause blood glucose to rise dangerously. A GP can review your HbA1c, weight and medications and discuss whether remission is realistic for you. This can begin with a telehealth consultation when clinically appropriate.
How much weight loss is needed for diabetes remission?
Can I stop my diabetes medicine if my blood sugar is normal?
No, not without medical advice. Your blood glucose may be in the healthy range because your medication is working. Stopping it suddenly can cause levels to rise again. If you’re considering stopping or changing your medication, speak with your GP or diabetes healthcare team first.
Is type 2 diabetes remission permanent?
Can a low-carbohydrate diet put type 2 diabetes into remission?
The RACGP rates the evidence as medium to low, and it applies to people who can stick with a low- or very-low-carbohydrate approach for at least six months. Longer-term studies are still needed to show whether remission lasts. Speak with your GP or a dietitian before making big dietary changes, particularly if you take diabetes medicines.
What is DiRECT-Aus?
DiRECT-Aus was an Australian primary care study involving 155 adults with late-onset diabetes,of up to six years’ duration, who were not using insulin. At 12 months, 56% of participants were in remission after an intensive weight-management program that included Total Diet Replacement.
Can you achieve remission if you have had type 2 diabetes for many years?
Do I still need diabetes checks after remission?
Yes. Remission doesn’t mean you can stop your usual diabetes care, because blood glucose can rise again and complications can still develop. Regular HbA1c tests and checks of your eyes, feet, kidneys, blood pressure and cholesterol are still recommended. Diabetes Australia advises at least annual monitoring, including the checks that form part of the Annual Cycle of Care. A GP can arrange these and tell you how often you need them.
What if I do not achieve remission?
Not achieving remission doesn’t mean you have failed. Remission depends on factors such as genetics, age and how long you have had diabetes, which are outside your control. Lowering your HbA1c, improving your weight where appropriate and becoming more physically active can still improve your health and reduce the risk of diabetes-related complications. A GP can review your treatment and help you set realistic goals, and may refer you to a dietitian or diabetes educator if appropriate.
Conclusion
Type 2 diabetes can go into remission for some people, most often after substantial weight loss achieved with medical support. Remission isn’t a cure, it doesn’t last for everyone, and it needs regular HbA1c checks. If you’re thinking about remission, start with a conversation with your GP rather than stopping medicines or starting a very low-calorie diet on your own.
HelloGP - Disclaimer
This article is for general information only and does not replace professional medical advice. Telehealth is not suitable for emergencies. If you have an emergency or are at immediate risk, call 000 or visit your nearest emergency department.