Once a Diabetic, always a Diabetic?

[pjgtech]

If people do achieve "remission" and are able to lose weight, control their diet and come off Diabetic meds, are they still considered to be a Diabetic?
Thinking more about medical peeps really, GP, Diabetic nurse, etc, do you remain on their books as a Diabetic and still get the feet, eye checks, etc?
I assume there is no "cut off" time, when you are assumed to have beaten it.
I would imagine that you are always still at risk of getting Diabetic symptoms at some point, so still need to be monitored.

 

[Martin.A]

If people do achieve "remission" and are able to lose weight, control their diet and come off Diabetic meds, are they still considered to be a Diabetic?
Thinking more about medical peeps really, GP, Diabetic nurse, etc, do you remain on their books as a Diabetic and still get the feet, eye checks, etc?
I assume there is no "cut off" time, when you are assumed to have beaten it.
I would imagine that you are always still at risk of getting Diabetic symptoms at some point, so still need to be monitored.

Yes, you're still considered to be diabetic as remission doesn't mean cured. I'm still getting my eye checks and diabetes reviews, almost 5 years on. This pretty well covers all the bases:-

What is type 2 diabetes remission?

Jump to: What is remission?

www.diabetes.org.uk

 

[Sharron1]

It's like asthma, a chronic ailment but can be well managed, but once an asthmatic always an asthmatic. These things never go away. Alas.

 

[pjgtech]

Yes, you're still considered to be diabetic as remission doesn't mean cured. I'm still getting my eye checks and diabetes reviews, almost 5 years on. This pretty well covers all the bases:-

What is type 2 diabetes remission?

Jump to: What is remission?

www.diabetes.org.uk

Thank you for the link, just read it, as I had not seen it before, so very useful to know, Cheers. 🙂

 

[everydayupsanddowns]

We have had a few members over the years whose GPs talked about “taking them off the diabetes register”, which is odd, because it isn’t really a thing. There’s no centralised list of who has or hasn’t got diabetes.

But I suspect it just meant that the individual GP practice decided to treat that person as if they no longer had diabetes, or that it was “resolved” (another phrase that was sometimes used).

This all predated the more recent research into diabetes remission (which is not ‘cure’ or removal). One of the things about remission is that it can remain for a while, but there’s no guarantee that a person may not move back towards diabetes.

However in a recent thread about whether some dietary management approaches were unsustainable, there were examples of people maintaining non-diabetes numbers for getting on for 20 years - so short term relapses are by no means inevitable!

 

[beating_my_betes]

If people do achieve "remission" and are able to lose weight, control their diet and come off Diabetic meds, are they still considered to be a Diabetic?

It depends, imo.

 

[harbottle]

There is a diagnosis code in the UK for Type 2 Diabetes (In Remission). This is for people with T2 who have managed to keep hba1c < 48 for 3 months without medication. Even though this is on your medical record, they still advise the annual checks and you'll still get called in for an eye test.

My code has been changed to this with instructions to maintain weight loss and be careful with diet.

There's also a code Diabetes (Resolved), which is for diabetes caused by other reasons - gestational, I think, and steroid induced.

 

[Burylancs]

If people do achieve "remission" and are able to lose weight, control their diet and come off Diabetic meds, are they still considered to be a Diabetic?
Thinking more about medical peeps really, GP, Diabetic nurse, etc, do you remain on their books as a Diabetic and still get the feet, eye checks, etc?
I assume there is no "cut off" time, when you are assumed to have beaten it.
I would imagine that you are always still at risk of getting Diabetic symptoms at some point, so still need to be monitored.

Good Control of Type 2 Diabetes is a Process not an end-state. Once you have achieved your current targets it's basically more of the same every day for the rest of your life. Although due to the progression of the condition T2s usually have walk up through the quantity and quality of medical help.
Diabetes UK used to publish a list of the 15 checks you should have at least annually. Some won't apply to you. Many T2s don't receive them all so it's good to get that list and keep your med team up to scratch with your annual reviews. Folks on the Support Groups used to regularly report on their 'MOTs'.

 

[Meglorien]

Good Control of Type 2 Diabetes is a Process not an end-state. Once you have achieved your current targets it's more of the same every day for the rest of your life.
Diabetes UK used to publish a list of the 15 checks you should have at least annually. Some won't apply to you. Many T2s don't receive them all so it's good to get that list and keep your med team up to scratch with your annual reviews.

Where is this list?

 

[silentsquirrel]

Where is this list?

Diabetes health checks (annual review)

Diabetes can cause other health problems that can become serious if not picked up and monitored or treated in the early stages. So regular diabetes health checks – sometimes called your yearly or annual review – are part of your routine NHS treatment. What diabetes health checks should I be...

www.diabetes.org.uk

This looks like the latest version.

 

[beating_my_betes]

Good Control of Type 2 Diabetes is a Process not an end-state. Once you have achieved your current targets it's basically more of the same every day for the rest of your life. Although due to the progression of the condition[...]

I'm a little confused. There seems to be a contradiction here, with regard to your claims of progression and the notion of good control. Also, are you saying that someone who is under the threshold for diabetes is still diabetic?

 

[Martin.A]

Also, are you saying that someone who is under the threshold for diabetes is still diabetic?

There's no cure for diabetes. Once you're diagnosed it's for life, even if you're in remission.

 

[harbottle]

Even if you've gone down the weight loss route and seen beta-cell functionality improve, it will still return if you lose weight.
The root cause is genetic (And I believe it's been known for some time that there's a gene that causes beta-cells to stop working under certain conditions.)

 

[Burylancs]

I'm a little confused. There seems to be a contradiction here, with regard to your claims of progression and the notion of good control. Also, are you saying that someone who is under the threshold for diabetes is still diabetic?

There is no contradiction between ‘progression’ and ‘good control’. Good Control won’t stop invisible damage being done to your metabolism and organs. And Good Control reduces the risk of complications; it doesn't eliminate the risk. The most cited evidence on this is the huge UKPDS study which found that Good Control reduces the risk of the four major complications by 22%. Which means you still have 78% of your original risk of one of the four major complications even with Good Control.
Once diagnosed securely with Type 2 the diagnostic criteria, pre-diabetic, non-diabetic, ‘normal’ etc go out of the window and are irrelevant. In the current state of knowledge Type 2 Diabetes is a life sentence with no ‘remission’ for good behaviour.

 

[beating_my_betes]

There's no cure for diabetes. Once you're diagnosed it's for life, even if you're in remission.

Can you explain the thinking behind this?

 

[beating_my_betes]

Even if you've gone down the weight loss route and seen beta-cell functionality improve, it will still return if you lose weight.

Can you shre some evidence for this?

 

[beating_my_betes]

In the current state of knowledge Type 2 Diabetes is a life sentence with no ‘remission’ for good behaviour.

Do you have some citations for this?

 

[harbottle]

Can you shre some evidence for this?

In the DIRECT trial, in which the majority of people who obtained remission put the weight back on again and the condition returned.

 

[beating_my_betes]

In the DIRECT trial, in which the majority of people who obtained remission put the weight back on again and the condition returned.

Of course. But this presumes people will put the weight back on. What if they don't?

 

[Martin.A]

Can you explain the thinking behind this?

Suggest you read this:-

Is there a cure for diabetes?

There isn’t a cure for diabetes right now. But our scientists across the UK are pushing boundaries and taking steps to build a future where diabetes can do no harm. Our scientists are busy with exciting developments. Here, we take a look at the life-changing research taking place both for type...

www.diabetes.org.uk