The Real Key for Reversing Diabetes

Dr. Sears on Reversing Diabetes

If you’ve been told you have Type 2 Diabetes, chances are, you were also told that you had better get used to it, and that it will be a life-long condition. In fact, if you develop diabetes by age 40, there is clear data that shows the condition will take 11-14 years off your lifespan. You could have gastric bypass surgery and reverse the symptoms of diabetes before you even lose any weight. But then you risk a lifetime of malnutrition. Gastric bypass is NOT your only option.

Hope for People with Diabetes

A recent New York Times article entitled “Hope for Reversing Type 2 Diabetes” addressed this question. It’s not a new miracle drug. Instead, the article states the old-fashioned method of losing weight and keeping it off can reverse diabetes.

However, another article soon to be published in Diabetes Care, “Very low calorie diet and 6 months of weight stability in type 2 diabetes,” has a new breakthrough in treating diabetes. Is this really a new breakthrough? Or is this just an absence of knowledge of diabetes research that is once again rising to the surface.

In fact, while losing weight will cause a rapid decrease in blood sugar levels, it’s not just the weight loss, but the reduction in insulin resistance that is the real secret to reversing diabetes. This is also the reason that gastric bypass surgery works to reduce blood sugar before any appreciable weight loss is seen. When people are eating less, which they would after gastric bypass surgery, their pancreas produces less insulin because there is less sugar in the blood.

The Zone Got It Right Years Ago – And It Continues To Be Right Today

In the Diabetes Care study, diabetic patients were placed on a liquid Zone-like diet (40% carbohydrates, 30% protein, and 30% fat) using medical shakes that provided 1,100 calories per day. This diabetic study was published three years after I wrote The Zone giving the same dietary advice. I wonder if that is a coincidence. On that liquid diet, participants were provided with 110 grams of carbohydrate, 82 grams of protein and 45 grams of fat.

The study proved that these are all reasonable amounts of nutrients and they are balanced.  Within four days of starting these shakes, all indications of insulin resistance were gone before any weight was lost. This is the same result that is seen in gastric bypass surgery.

So in other words, the appropriate balance of nutrients and the right amount of calories was beneficial to reducing insulin resistance, and are very effective in the long-term treatment of type 2 diabetics. This is essentially identical to my Zone Diet recommendations almost two decades ago.

The reason all of these “old” dietary interventions work is because they decrease insulin resistance. It is the reduction of insulin resistance, rather than simple weight loss that reverses diabetes.

Overlooking the successes of previously published literature, another study used an even lower calorie diet of 624 calories consisting of three “medical” shakes and then letting the subjects consume up to another four cups of non-starchy vegetables providing another 100 calories for whopping maximum of 724 calories per day for six weeks.

That calorie intake was low enough to cause the body to defend itself from what it perceives as starvation and ironically caused insulin resistance. At 1,100 calories per day, those innate biological defense mechanisms are usually circumvented leading to a reduction of insulin resistance. This may have been why about 60% of study particpants had no insulin resistance reduction. It also shows that a desirable caloric intake, and correct food choices, can reduce insulin resistance and help prevent or reverse diabetes – just like in The Zone.

How to Reverse Diabetes in Real Life

The real secret for treating Type 2 Diabetes is to keep insulin resistance under control for a lifetime. To do that, there has to be a reasonable alternative to either gastric bypass surgery or using “medical” shakes that get boring quickly, since people don’t live their lives and eat meals within the vacuum of scientific studies.

That’s why I developed Zone PastaRx® several years ago  ̶  to make it easier to consume all of the non-starchy vegetables needed to reduce insulin resistance without boredom. In fact, you could think of Zone Pasta as a “vegetable helper.”

Frankly, when given a choice between eating a bowl of vegetables, or a bowl of pasta with vegetables in it, most people would choose the pasta with vegetables. Using Zone Pasta as replacement for protein, it is now easy to maintain the ideal dietary conditions to reduce insulin resistance long-term.

My recent clinical study supports this statement. In this study, subjects had to eat prepared meals consisting of pasta and non-starchy vegetables twice a day for six weeks. Each meal had an equal amount of calories. The cooking was done for them. All they had to do was warm it up in a microwave and eat. The only difference was that one group got pasta meals containing our Patented Performance Protein in Zone PastaRx, and the other group got pasta meals made with gluten-free pasta.

Unlike most diet studies, the compliance for both types of pasta (even with the inclusion of non-starchy vegetables) was excellent. Both diets were also calorie-restricted so that the weight loss was equal in both groups.

There was no reduction of insulin resistance in the subjects getting the gluten-free pasta, whereas those eating the Zone Pasta had their insulin resistance reduced by 26%. This study proves that to treat and reverse Type 2 Diabetes, the focus has to be on reducing insulin resistance through diet rather than simply trying to lose weight. Zone Pasta can help people stick to a diet that reduces insulin resistance.

Do You Have Insulin Resistance?

You don’t have to be diabetic to have insulin resistance. In fact, according to studies, 16% of healthy, normal weight individuals have significant levels of insulin resistance. This increases to 31% in an otherwise-healthy, obese individual, indicating that you can’t tell if you have insulin resistance simply based on weight alone.

By the time people develop metabolic syndrome or diabetes, which is likely when following the Standard American Diet, the percentage of those with significant insulin resistance rises to 100%. According to a recent article in JAMA, as of 2012, more than 50% of American adults have significant levels of insulin resistance. This trend is not good news for the future of health or health care in America.

Because of this growing epidemic of insulin resistance, I urge you to take our Insulin Resistance Quiz to see how much insulin resistance you may actually have. If your levels are high, you should consider using Zone Pasta as a “vegetable helper” by following a wide variety Zone Pasta meals which are all under 400 calories.

If you eat three Zone Pasta meals per day, that’s about 1,200 calories per day. Zone PastaRx Orzo  even makes a great oatmeal dish in the morning. You will also get the right macronutrient balance to reduce insulin resistance, while consuming enough calories to overcome powerful biological defense mechanisms that occur when you restrict calories too much.

Of course, all of these recommendations assume you to like to eat pasta. If you don’t, then there is always either gastric bypass surgery or a lifetime of “tasty” medical shakes to help you manage insulin resistance.


  1. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, and Williamson DF. “Lifetime risk for diabetes mellitus in the United States.” JAMA 2003 290:884-1890 (2003).
  2. Rabin RC. “Hope for reversing type 2 diabetes.” New York Times, April 18 (2016).
  3. Steven S, Hollingsworth KG, Al-Mraheh A, Avery, L, Aribisala B, Caslake M, and Taylor R. “Very low calorie diet and 6 months of weight stability in type 2 diabetes.” Diabetes Care doi:10.2337/dc15-1942 (2016).
  4. Sears B and Perry M. “The role of fatty acids in insulin resistance.”
    Lipids Health Dis 14:121 (2015).
  5. Markovic TP, Jenkins AB, Campbell LV, Furler SM, Kraegen EW, and Chisholm DJ. “The determinants of glycemic responses to diet restriction and weight loss in obesity and NIDDM.” Diabetes Care 21:687-694 (1998).
  6. Hamdy O and Carver C. “The Why WAIT program: improving clinical outcomes through weight management in type 2 diabetes.” Curr Diab Rep 8:413-420 (2008).
  7. McLaughlin T, Allison G, Abbasi F, Lamendola C, and Reaven G. “Prevalence of insulin resistance and associated cardiovascular disease risk factors among normal weight, overweight, and obese individuals.” Metabolism 2004 53:495-499 (2004).
  8. Menke A, Casagrande S, Geiss L, and Cowie CC. “Prevalence of and trends in diabetes among adults in the United States, 1988-2012.” JAMA 314:1021-1029 (2015).

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About Dr. Barry Sears

Dr. Barry Sears is a leading authority on the impact of the diet on hormonal response, genetic expression, and inflammation. A former research scientist at the Boston University School of Medicine and the Massachusetts Institute of Technology, Dr. Sears has dedicated his research efforts over the past 45 years to the study of lipids. He has published 40 scientific articles and holds 14 U.S. patents in the areas of intravenous drug delivery systems and hormonal regulation for the treatment of cardiovascular disease. He has also written 14 books, including the New York Times #1 best-seller, The Zone, which have sold more than 6 million copies in the U.S. and have been translated into 22 different languages.


  1. Dave Lembo

    Hello Dr. Sears,
    I recently learned of you after visiting a new doctor. He informed me that I have Metabolic Syndrome. I am 49 and approximately 80-100lbs over weight (I am 5’10” 279lbs). My A1C is 5.7, my Blood Glucose is 104, My Triglicerides are 195, my good cholesterol is Low 23, bad cholesterol is 132.

    I take medication for High Blood Pressure, Cholesterol, Tryglicerides, gout, prilosec and now he just added metforman. I just ordered some of your zone pasta and your fish oil.

    What suggestions do you have for me?

  2. Major facilitator superfamily

    Grapefruit is rich in calciu. Calcium in the grapefruit is very good for prevention and treatment of diabetes. The experimental study confirmed that grapefruit can not only improve the calcium in patients with diabetes osteoporosis, but also go against the development of diabetic nephropathy.

  3. Rita Groszmann

    I am Type II diabetic, 64 years of age and over weight (about 70 pounds overweight). I am so confused about the right diet for managing my diabetes. Mark Hyman says that carbohydrates raise blood sugar but so does too much protein. He recommends a high fat, moderate protein and low carbohydrate diet as a way to manage diabetes…fat does not raise blood sugar. Your diet recommendation is high protein, moderate carbs and low fat to manage blood sugar. Which is correct for someone like me? Both diets would be with healthy fats.

    • Barry Sears

      Managing diabetes means reducing insulin resistance. To reduce insulin resistance you have to reduce inflammation in the hypothalamus, the fat cells, the liver, and the muscles. It seems like a tall order, but diet remains the most effective tool you have. The fastest way to lose insulin resistance is to restrict calories. But to make that meaningful, you can never be hungry or fatigued in the process. To reach that goal you will need to follow a protein-adequate, moderate carbohydrate diet rich in non-starchy vegetables and limited amounts of fruits, and low in fat mainly consisting primarily of monounsaturated fat and low in saturated and omega-6 fat. That is the real definition of the Zone Diet. All the Zone meals found at meet that criteria. I would recommend following those meals strictly for three days. If you are not hungry or tired for five hours after each meal, then you have dietary game plan for managing diabetes for a lifetime.

  4. Jody Melton

    My daughter has been diagnosed with Ehler Danlos Hypermobility Type, RA, & Fibromyalgia. Both her Pain Management Doctor and Rheumatologist have recommended a gluten free diet because gluten can cause inflammation. Would your pasta be a viable and safe alternative for her?

    • Dr. Sears

      Your physicians are correct that the underlying cause of these diverse conditions is increased inflammation. I believe they are incorrect in assuming that gluten has anything to do with that inflammation. I have wrote about in a recent blog on “gluten sensitivity”. There is little credible science to support the existence of such a condition. On the other hand, there is also robust evidence demonstrating that high-dose omega-3 fatty acids reduce inflammation. I would suggest doing a AA/EPA test to determine if he has a high level of cellular inflammation. If so, then I would recommend starting with high-dose omega-3 fatty acids coupled with a strict Zone Diet. If your daughter is seeing success after 60 days, then you may want to try adding the Zone Pasta since it makes the Zone Diet easier to follow. If she sees even further improvement, that the idea gluten has anything to do with her condition is moot since Zone Pasta is rich in gluten.

  5. Rosie

    I live in Toronto Canada and am a long time Zone diet fan – where can I buy the Zone pasta?

  6. James Taylor

    Other medical authors have had success treating diabetes with an unlimited 90% vegetable diet vs 75% in your book. Massive weight loss & secession of insulin resistance are by-products of eating for maximum nutrients ie. polyphenols. The two options you cite for treating diabetes & your vegetable pasta are not the only ones. Consumers associate a pasta with weight gain, no matter how healthy. I’ve had pizza with a cauliflower crust & it was delicious, but I haven’t eaten pasta for the last 40 years.

    • Dr. Sears

      I certainly hope that you don’t get the impression that using the Zone Pasta is only way to treat diabetes. My dietary recommendations since 1995 and those of the Joslin Diabetes Research Foundation since 2007 have been the same; calorie restriction using a balanced diet with approximately 40% of calories coming from low glycemic load carbohydrates, 30% from low-fat protein, and 30% from monounsaturated fat. When you do the calculations, this is protein-adequate, carbohydrate-moderate, and low-fat diet. The balance of macronutrients allows to restrict calories w without hunger or fatigue. When adhered to, the Zone Diet recommendations produce consistent clinical success in controlled trials. Unfortunately we live in an uncontrolled world. The Zone Pasta was developed to as an alternative to gastric bypass surgery that also works very well in managing diabetes. Therefore it offers another option to those considering gastric bypass surgery who are not extremely compliant with the Zone Diet. This is because the Zone Pasta offers appetite suppression that is not available with normal protein (both animal or vegetable) because of its patented structure. There are many paths to the top of the mountain of blood glucose control. You simply find the one that works best for you and stick with it for lifetime.

      Although polyphenols have a benefit in helping to reduce insulin resistance, as I point out in my recent review article mentioned in the blog, it the reduction of inflammation that has the major role in reversing insulin resistance.

  7. Mary Rose

    Dr Sears, I love the Zone. It’s been part of my life since your first book & has saved me from migraines & other food-related pain.

    I like vegetables, yet sometimes it’s hard to eat enough & find quality protein to accompany them, so I understand people are challenged by this. Still, I persevere because the results are worth it. I eat Zone Pasta occasionally & enjoy it. But it is processed food & not something I figure I need to eat every day.

    This article concludes that the only alternative to eating Zone Pasta is to have gastric bypass surgery or consume medical shakes. What happened to encouraging a balanced whole-foods diet?

    If you mean to say Zone Pasta helps people ease off the Standard American Diet, it would be helpful to state this in the conclusion. Otherwise, it looks like you are now recommending a Zone processed-foods diet. I’ll stick to my whole foods, thank you.

    • Dr. Sears

      The unique aspect of the Zone Pasta is its superior appetite suppression compared to other forms of protein. The more your appetite is suppressed, the easier it is to follow a calorie-restricted program for lifetime. If you are balancing you meals according to Zone principles it is possible to obtain the same hormonal stimulation, but it also means never eating regular (or even gluten-free) pasta again. The Zone Pasta gives you greater flexibility with a totally sustainable source of protein.

    • Lynda Maccagnan

      I agree with you. I’m surprised Dr. Sears would make a statement like that. I prefer meat and vegetables to pasta and breads so I really don’t feel the need to buy the Zone pasta.. Perhaps Dr. Sears figured if you already have diabetes, you might really like pasta and this is better than the standard processed stuff.

      • Dr. Sears

        In managing diabetes, we either all swim together or will all sink together because of the massive looming health care costs associated with the increased co-morbities that come with diabetes (heart disease, Alzhemerier’s, blindness, etc). The Zone Pasta was developed for those who have a difficult time to control their appetite due to hormonal imbalance coming from the gut. It would be nice if all diabetics would follow a strict Zone Diet, but continually reach to help manage the greatest number. Since more than 50% of Americans have either pre-diabetes or diabetes, the development of Zone Pasta gives them a better chance to live a longer and better life without drugs or gastric bypass surgery.

    • Dale Baskett

      I liked reading this format provided on the benefit of the zone pasta for calorie balance and carb/fat/protein balance as a weapon for changing the insulin resistance status, can one do the same with a disciplined eating plan of whole foods at the correct measured balances necessary ?

      I have reversed my 11.5 A 1 C to 5.2 in less than a year without zone pasta products, although I realize the pasta product is very effective. Is this question and my situation viable to anyone that disciplines themselves to what I did or will the pasta have to be involved to provide results for the masses and not just individual cases like myself ?

      • Dr. Sears

        Your great success only shows that will dietary diligence, the Zone Diet is remarkably effective for managing diabetes. The Zone Pasta simply makes it easier to follow the Zone Diet for the vast majority.

  8. Kim

    Is there a linguine or fettucini in the making?! That would be great too! Thank you for sound science Dr. Sears.

  9. Vicki Barnett

    I appreciate the thought that zone pasta is a vegetable helper. I thought it was to be a protein substitute. I’m going to try this. Thanks

    • Dr. Sears

      It is both a protein substitute to improves muscle mass formation as well as providing the ideal meal companion to encourage greater consumption of non-starchy vegetables.

  10. mark mcginn

    great article, study and recommendations, very interesting that too little calorie intake actually caused insulin resistance in that study.

    Barry, could that also be a issue in fasting to boost metabolism, too little calorie in-take not effecting insulin resistance ?

    also, did the 724 calorie group show any weight loss, even though it may not have been fat loss ?

    • Dr. Sears

      There was actually no change in insulin resistance in the muscle (the primary disposal site of excess glucose in the blood). When the calorie intake is too low, the metabolism begins to slow down to conserve energy. This is why I like to have at least 1,200 calories per day to circumvent those biological defense systems.


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