Can a person with type 2 diabetes control his diabetes with exercise and nutrition instead of using insulin?
So, 3 and 1/2 years ago, I'd get up and test my blood sugar and inject a minimum of 60 units of Lantus. If it was particularly high, I'd inject a bit more Lantus to start the day. I carried around a Novolog pen. If I was eating a pretty starchy or high carb meal, I'd inject 15 to 20 units to help control the blood sugar spike.
My A1C was in the 9's (over 190) even with all this treatment. I was taking 3 blood pressure medicines to keep my blood pressure under control. I wasn't particularly obese and was still within the "normal" range for BMI. I wasn't uncomfortable with my weight, but I was damn sure uncomfortable with those blood sugars.
So, I started a ketogenic lifestyle. I cut my carbs to the bare minimum. I continued to test to see what foods trigger my blood sugar. (Sugar alcohols in "sugar free" foods really give it a problem) Mostly, I would eat under 25g a day of carbohydrate and I'd imagine some days even near zero.
My fasting blood sugar started dropping. I tapered my insulin down but I knew that type 2 diabetes is really insulin resistance caused by too much insulin. So, as soon as my sugars dropped to the 160 level I ditched insulin. I knew that I was not eating anything to really spike my blood sugar and that was true. It was pretty level at that point at 160.
At some point I started riding my bicycle again. That could make a major drop. I could be 160 in the morning, take a 15 minute bike ride and come back and test at 100. (Turns out muscles are a big part of insulin resistance/sensitivity.)
Still, you need to realize how big your levels of body fat are in the equation. As I dropped fat, the sugar levels would find new lower plateaus. For a time, I was in the high 130's. I was a bit frustrated and experimented with my doctors and other drugs. Nothing quite worked out and one of these SGLT drugs nearly killed me with normal blood sugar ketoacidosis.
In the meantime fat continued to drop off. When I reached about the 50 to 55 pound mark from where I started, I started seeing "regular person normal" numbers. I still take 1000mg metformin day and night, but if I do it's nothing to see numbers in the low 90's. Still, I must avoid those "sugar free" treats. They still make my blood sugar go up.
So, I am off insulin. I am off all 3 of those blood pressure medicines and have really normal blood pressure. I progressed from taking all those expensive drugs and now just take my very cheap metformin. In addition to my bike, I use small dumbbells around the house to help build back muscles in my arms and shoulders.
So, my answer is an absolute YES. It's been proven over and over. There is a virtual clinic called Virta Health that is getting diabetics off insulin with a low carb ketogenic diet. They have actually published their studies in peer reviewed journals. There are doctors around the world that are using that treatment on their patients with the same results.
I may be my own n=1 science experiment but when you get lots and lots of people doing the same experiment with the same results it's probably time to admit there is something there that works.