Can type 2 diabetes be reversed?

Reviewed by the JForH team · 2026-10-30

Sometimes. Doctors call it remission: an HbA1c below 48 mmol/mol (6.5%) at least 3 months after stopping all glucose-lowering medicine. In the UK DiRECT trial, 46% of people on a supervised soups and shakes diet were in remission at 1 year. In the NHS programme in England, 32% of people who completed it with blood test results were. It isn't a cure, results vary, and you should never stop a medicine without your GP.

Can type 2 diabetes be reversed?

For some people, yes, though doctors prefer the word remission. It means your HbA1c stays below 48 mmol/mol (6.5%) when it's checked at least 3 months after you stop all glucose-lowering medicine.

That definition comes from a 2021 international consensus, backed by Diabetes UK with the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes UK describes remission as blood sugar going back to a safe, non-diabetes level long-term.

An HbA1c under 48 while you still take metformin, gliclazide, insulin or a GLP-1 injection is good control, not remission. It's still worth having. It just isn't the same thing.

Can type 2 diabetes be reversed permanently?

No one can promise that. The experts chose 'remission' rather than 'cure' because diabetes can come back, most often if weight comes back.

People in remission still need an HbA1c at least once a year. They still need their eye screening, foot checks and kidney tests too, because the years of high sugar before remission still count. Diabetes UK also says remission may not be possible for everyone.

What is the soups and shakes diet on the NHS?

It's the first stage of the NHS Type 2 Diabetes Path to Remission programme in England. For 12 weeks you replace all your meals with soups and shakes that add up to 800 to 900 calories a day. NICE says low-calorie diets for type 2 diabetes should follow this programme.

The programme lasts a year in three stages:

1. 12 weeks of total diet replacement: soups and shakes only.
2. Food reintroduction: slowly bringing normal meals back.
3. Maintenance: support with eating and moving more, to keep the weight off.

It's free on the NHS. In DiRECT, the trial behind it, diabetes and blood pressure medicines were stopped under supervision when the diet began, so expect your medicines to be reviewed before you start.

Who can get the NHS Path to Remission programme?

You're referred by your GP practice. One NHS area, North East London, lists these criteria, and NHS England gives the same core ones:

• aged 18 to 65,
• type 2 diabetes diagnosed in the last 6 years,
• a BMI over 27, or over 25 if you are of Black, Asian or other minority ethnic origin.

You can't join if you:

• use insulin,
• are pregnant or planning a pregnancy in the next 12 months, or
• have had or are waiting for weight-loss surgery.

There are also HbA1c criteria for joining. We couldn't confirm the exact figures from the national specification, so ask your GP whether your latest result qualifies.

The programme is run by NHS England. Scotland, Wales and Northern Ireland organise weight management and remission support in their own ways. We haven't checked their details, so ask your GP or diabetes team what's on offer where you live.

How many people reach remission on the NHS programme?

About 1 in 3 of those who complete it. A 2024 study in The Lancet Diabetes and Endocrinology looked at the first 1,740 people to start:

• 55% (960 people) completed the programme.
• People who completed it lost 10.3 kg on average, 9.3% of their weight.
• 32% of completers with HbA1c results were in remission at 1 year.
• Among the 710 starters with full HbA1c results, 27% were in remission.

In that study, remission meant two HbA1c readings below 48 mmol/mol at least 3 months apart, with no diabetes medicine for 3 months before the first.

So it works for many people, but not most. Almost half didn't finish, and that's a common outcome, not a personal failure.

What did the DiRECT trial find?

DiRECT was the UK trial the NHS programme is based on. It ran in 49 GP practices in Scotland and the north of England, with Diabetes UK funding. Adults diagnosed in the previous 6 years, not on insulin, stopped their diabetes and blood pressure medicines under supervision. They lived on a formula diet of about 825 to 853 calories a day for 3 to 5 months, then went back to food with ongoing support.

The real-world NHS result (32% of completers) is lower than DiRECT's 46%. Fewer people finished the NHS programme, and results in routine care are often lower than in a trial.

The 5-year figures come from an extension that only some people joined, so they're less certain. People who stayed in remission longer had fewer serious medical problems over the 5 years.

How much weight do you need to lose?

In DiRECT, the more people lost, the more likely remission was. At 12 months:

15 kg is about 2 stone 5 lb. Keeping it off is the hard part. Only about 1 in 4 people in the DiRECT programme group had kept off 10 kg (about 1 stone 8 lb) at 2 years.

Can diet and exercise alone reverse type 2 diabetes?

Sometimes, but less often than with a soups and shakes programme. Diabetes UK says there are different ways to try for remission safely.

A 2021 review in The BMJ found that after 6 months, more people on low-carb diets had an HbA1c below 48 mmol/mol (6.5%) than on other diets. By 12 months the gap had narrowed.

Does weight-loss surgery reverse type 2 diabetes?

It can, for some people with a high BMI. In an Italian trial published in The Lancet in 2021, 37.5% of people who had surgery stayed in remission for 10 years, against 5.5% of those on medicines. More than half of those in remission at 2 years saw their diabetes come back later. Surgery has real risks, and your GP can tell you whether a referral is possible.

If my HbA1c is normal on a GLP-1 injection, am I in remission?

No. Remission means a normal HbA1c without any glucose-lowering medicine for at least 3 months. A good result on semaglutide or tirzepatide means the medicine is working.

In a trial of people without diabetes who stopped semaglutide, about two-thirds of the weight they had lost came back within a year. Don't stop a GLP-1 to test whether you're in remission. Talk to your GP about it.

Can I stop my diabetes medicine on my own?

No. Never stop or cut a diabetes or blood pressure medicine without your GP or diabetes nurse.

On a low-calorie diet, some medicines need to come down quickly, especially gliclazide and insulin, which can cause hypos. Others may need to stay. In DiRECT and the NHS programme, any changes were made with the care team, not by people on their own.

What happens to free prescriptions if I'm in remission?

In England, the medical exemption certificate covers diabetes 'except where treatment is by diet alone'. So if you come off all diabetes medicine, you may no longer qualify, and prescriptions cost £9.90 an item in 2026/27. Ask your GP surgery. In Scotland, Wales and Northern Ireland, prescriptions are free for everyone.

What if I have prediabetes?

Then you are trying to prevent type 2, not reverse it. In England, an HbA1c of 42–47 mmol/mol in the last 12 months can make you eligible for the NHS Diabetes Prevention Programme, Healthier You. Some areas let you refer yourself.

What should I ask my GP about remission?

• Do I meet the criteria for the NHS Path to Remission programme?
• Which of my medicines would change on a low-calorie diet, and who will monitor me?
• What HbA1c would count as remission for me, and when should we check it?
• If I don't qualify, what weight management support is there locally?

Diabetes UK has remission videos in Arabic, Gujarati, Punjabi, Sylheti and Urdu, which can help if you or your family prefer another language.

See if a doctor-led programme could suit you (free check)

Last updated: 2026-10-30. Educational information, not medical advice. Talk to your doctor before changing your treatment.