Written by Dr. Ryan Kneessi, ND
Quick answer: Type 2 diabetes develops when the body becomes resistant to insulin and the pancreas can no longer keep up, so blood sugar stays high. It is diagnosed with fasting glucose, A1C or glucose tolerance tests. An integrative approach combines your medical treatment with nutrition, movement, sleep, stress care and, when appropriate, targeted supplements, always coordinated with your prescriber.
Key takeaways
Type 2 diabetes develops when the body becomes resistant to insulin and the pancreas can no longer keep up.
It is identified with fasting glucose, A1C or glucose tolerance tests.
An integrative approach adds nutrition, movement, sleep and stress care to medical care, always coordinated with your prescriber.
How type 2 diabetes develops
With insulin resistance, cells respond less to insulin, so glucose stays in the blood. Over time comes beta-cell strain, as the pancreas works harder and insulin output eventually falls. Stress hormones matter because cortisol raises blood sugar, and genetics, weight, inactivity and sleep all affect risk.
Common symptoms
Common symptoms include increased thirst and urination, fatigue, blurred vision, slow-healing cuts, and numbness or tingling in the hands or feet.
Many people have no symptoms at first, which is why screening matters.
How it is diagnosed
According to the NIDDK, diabetes is diagnosed with a fasting plasma glucose of 126 or higher, an A1C of 6.5 or higher, or a 2-hour glucose tolerance result of 200 or higher. Results between normal and these cutoffs indicate prediabetes.
Integrative strategies
For nutrition, a lower-glycemic, fiber-rich, whole-food pattern is the base, and some people use paleo-style or ketogenic approaches with medical supervision. For movement, aim for regular aerobic activity plus strength training. Sleep and stress both affect blood sugar.
Supplements such as alpha-lipoic acid, chromium, magnesium, omega-3s, vitamin D and probiotics can be chosen with your provider (see supplements for blood sugar).
Low-carb diets and some supplements can lower blood sugar quickly. If you take insulin or sulfonylureas, your medications may need adjustment to avoid low blood sugar.
Medications still matter
Metformin, newer medications and insulin are proven tools. Integrative care works alongside them. Never stop or change diabetes medication without your prescriber. For day-to-day habits, see managing blood sugar naturally.
Diabetes and healthy aging
High blood sugar and insulin drive glycation (sugar binding to proteins), strain mitochondria, raise inflammation and disrupt nutrient-sensing pathways that help regulate aging. Better glucose control protects the heart, kidneys, nerves and brain over time.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have prediabetes or type 2 diabetes and want an integrative plan, or if your A1C is creeping up despite your efforts. The same is true if you want to coordinate diet and supplements with your medications, or if you have a family history and want to lower your risk.
See a medical provider promptly for very high or very low blood sugar, confusion, extreme thirst with vomiting, a foot wound that will not heal, or chest pain.
What the research shows
Lifestyle change has strong trial evidence in type 2 diabetes. In the Diabetes Prevention Program trial reported by Knowler and colleagues in 2002, 3,234 adults with raised blood sugar were assigned to a placebo, metformin (850 mg twice daily) or a lifestyle program aiming for 7% weight loss and 150 minutes of activity a week, and were followed for about 2.8 years. The lifestyle group was 58% less likely to develop diabetes than the placebo group, and the metformin group 31% less likely. These were people with prediabetes, so the results do not apply directly to people who already have diabetes.
For people who already have type 2 diabetes, the DiRECT trial by Lean and colleagues in 2018 tested an intensive weight program in 49 UK primary care practices. Of 306 adults who had developed type 2 diabetes within the previous 6 years, those in the program used a formula diet of about 850 calories a day for 3 to 5 months, then reintroduced food with support. After a year, 46% were in remission (HbA1c under 6.5% without diabetes medicines) compared with 4% with usual care, and remission was most common in those who lost 15 kg or more. The program was medically supervised, and medicines were stopped under a doctor’s care, which matters for safety.
Want an integrative plan that works with your medical care?
A free 15-minute consultation with Dr. Kneessi. No cost, no obligation. In-office in Odenton, MD or by telehealth.
Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Which lifestyle changes would make the biggest difference for my A1C alongside my current medication?
How can natural support work alongside the diabetes care I already get from my doctor?
Which food changes would make the biggest difference to my blood sugar?
How often should we review my A1c and other labs together?
Frequently asked questions
Can type 2 diabetes be managed naturally?
Diet, exercise and weight changes can improve blood sugar significantly. Many people still need medication, and that is fine.
What is the best diet for type 2 diabetes?
Low-glycemic, whole-food patterns work well. The best diet is one you can maintain, planned with your care team.
Is the keto diet safe with diabetes?
It can lower blood sugar quickly, so medications may need adjusting. Do it only with medical supervision.
Which supplements help blood sugar?
Berberine, chromium, magnesium and alpha-lipoic acid are studied. Check interactions with your prescriber.
Sources
- Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002. PMID: 11832527. https://pubmed.ncbi.nlm.nih.gov/11832527/
- Lean ME, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet 2018. PMID: 29221645. https://pubmed.ncbi.nlm.nih.gov/29221645/
- American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2024. Diabetes Care 2024. PMID: 38078589. https://pmc.ncbi.nlm.nih.gov/articles/PMC10725812/
- Colberg SR, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care 2016. PMID: 27926890. https://pmc.ncbi.nlm.nih.gov/articles/PMC6908414/
- Yin J, Xing H, Ye J. Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism 2008. PMID: 18442638. https://pmc.ncbi.nlm.nih.gov/articles/PMC2410097/
- MedlinePlus: Hemoglobin A1C (HbA1c) Test
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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