Type 2 diabetes
A chronic metabolic disease characterised by lasting high blood glucose resulting from insulin resistance combined with a gradual exhaustion of insulin secretion by the pancreas.
Type 2 diabetes (T2D) accounts for about 90% of diabetes. It develops in two stages: first insulin resistance (cells respond poorly to insulin), compensated by overproduction of insulin; then, after years, the pancreas wears out and can no longer keep up, and blood glucose stays high.
Diagnostic criteria: fasting blood glucose ≥ 1.26 g/L (on two occasions), or HbA1c ≥ 6.5% (HbA1c reflects average blood glucose over the previous 3 months).
An original angle (proven reversibility): long considered irreversible and progressive, T2D can now be put into remission in many cases, especially if it is recent. The British DiRECT study (2018) showed that significant weight loss (through a structured low-calorie diet) allowed about 46% of patients to reach remission without medication at 1 year, and the rate rises with the amount of weight lost.
The mechanism: losing fat from the liver and pancreas (ectopic fat) restores the function of those organs. This is Professor Roy Taylor’s “twin cycle” concept.
Levers for management and remission:
- Weight loss (especially visceral)
- Physical activity (muscle “pulls in” glucose without insulin)
- Cutting back on refined sugars and ultra-processed foods
- Sleep and stress management
This does not mean it is easy or universal, but the message of hope (remission is possible) contrasts with the old fatalism.