STEVE INSKEEP, HOST:
Many people think that once you have Type 2 diabetes, you are stuck with it. But with enough weight loss and exercise, people can get their blood sugar levels back down in the normal range. Research shows people need a lot of help to do that. Blake Farmer of our member station WPLN in Nashville visited a rural community in Tennessee.
BLAKE FARMER, BYLINE: A few years ago, as Wendy Norris turned 40, her feet started going numb. She thought it was from standing all day with her job at a nursing home.
WENDY NORRIS: But it wasn't. It was that neuropathy where my sugar was high, and I didn't know it.
FARMER: She had developed Type 2 diabetes, which runs in her family. It didn't help that her diet was overloaded with sodas, sweets and frozen dinners. So her doctor put her on insulin shots and told her to watch what she ate.
NORRIS: Well, you're sitting there thinking, well, what does that mean?
FARMER: Her doctor just kept upping her insulin to manage her spiking blood sugar. But then she lost her insurance. The insulin was costing hundreds of dollars a month she didn't have. At a nonprofit clinic, she was introduced to what seemed a radical idea - reversing her diagnosis altogether.
KAREN WICKHAM: This is lentil stew. What we're doing is introducing the people to high-fiber foods.
FARMER: Karen Wickham ladles out soup in an old church parsonage as participants arrive. She and her husband, Steve, are a couple of white-haired, semi-retired nurses. They travel around giving these six-week seminars, and they go deep, explaining the difference between sucrose and glucose and why white potatoes are more likely to spike blood sugar than sweet potatoes. They preach eating as much fiber as a stomach can stand and squeezing in light activity throughout the day. The Wickhams test blood sugar levels to track progress, and some see early results.
STEVE WICKHAM: Her blood sugar's going down. Give her a hand.
FARMER: If it sounds like a revival meeting, it kind of is. Steve and Karen Wickham are compelled by their Christian faith as Seventh-day Adventists, a denomination known for a focus on health.
S WICKHAM: I think God holds us responsible for living in the middle of this people and doing nothing.
FARMER: They moved to Grundy County, Tenn., and built their dream home but were disturbed by the illness around them. This scenic region has some of the shortest life expectancy in the nation and a sky-high rate of Type 2 diabetes. Karen Wickham says she's seen how bad it can get - blindness, kidney failure and even amputations.
K WICKHAM: When they get that diagnosis of diabetes, you expect this is what's going to happen to them until they finally pass away.
FARMER: The Wickhams give a disclaimer that their reversal program is not yet backed by piles of scientific literature, but they do cite promising studies from researchers like Roy Taylor of Newcastle University.
ROY TAYLOR: There just hasn't been information about the possibility of reversing diabetes.
FARMER: Type 2 diabetes is reversible in this sense - having diabetes means your A1C levels, measure of blood sugar, are elevated. You can drive those levels back down, even without medication. But the trick is to do it before the high blood sugar causes irreversible damage. Taylor says most studies do show that in most people, diabetes marches in one direction. But those studies also involve people who continued to put on weight. Taylor's research finds that by losing 30 pounds or so, Type 2 diabetes can be turned back in the early stages.
TAYLOR: I think the main headwinds are conceptual ones, scientists and doctors just believing that this is an irreversible condition because of what we see.
FARMER: But change is already on the horizon at the American Diabetes Association. It has a new position on what it calls remission. Dr John Buse at the University of North Carolina helped write it.
JOHN BUSE: We've known, literally since the 17th century, that diet is the key to managing diabetes.
FARMER: But it's hard to write a prescription for lifestyle change.
BUSE: Doctors don't have the time to do it well. And so we've often used sort of the short shrift - eat less carbohydrates and walk every day. That has basically no impact.
FARMER: But with education and counseling, it can be done, as Wendy Norris has already discovered.
NORRIS: You know, I felt like I was stuck having to take three or four shots a day the rest of my life. You know? I've got it down to one already. (Laughter). Yup.
FARMER: It takes discipline, but Norris says she's motivated by the prospect of no longer having Type 2 diabetes. For NPR News, I'm Blake Farmer in Grundy County, Tenn.
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INSKEEP: That story is part of a reporting partnership with NPR, WPLN in Nashville and Kaiser Health News.
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