I thought you couldn't reverse diabetes?

[lucy123]

HI

I am really confused as I thought we all thought that diabetes could not be reversed. However I recieved the diabetes.co.uk email this week with the following article?
http://www.diabetes.co.uk/reversing-diabetes.html

Have I misunderstood something. I would be very happy if I could reverse mine!🙂

 

[C*5_Dodger]

HI

I am really confused as I thought we all thought that diabetes could not be reversed. However I recieved the diabetes.co.uk email this week with the following article?
http://www.diabetes.co.uk/reversing-diabetes.html

Have I misunderstood something. I would be very happy if I could reverse mine!🙂

Dear Lucy,

Here's the relevent section from the article you quote:

"In some cases, people may find they are able to come off medication, although blood sugar levels should be checked regularly as reversing progression of diabetes is not a cure". They really mean you can slow the progression - there is no cure!

Regards Dodger

 

[margie]

Just in case we have any new members diabetes.co.uk and diabetes uk are not the same organisation.

I had a quick look at the article and its talking about reversing progression - which is a totally confusing term.

Diabetes is very complicated and has so many factors. Some people who have gastric band surgery discover that they no longer need any medication and their blood sugar results return to normal (I have a relative in the US where this happened). In their case their weight has been such that it has increased insulin resistance to a point their body could not cope, the removal of the weight means they can.

However, not everyone who loses weight will be so lucky.

Reversal is a bad term - because people think cure and its not, the issues that caused the diabetes to occur will still be there.

 

[lucy123]

I understand there is no cure - but if you can reverse yourself from type 2 to glucose intolerant and then even further back to normal through good control - that is good isn't it. I understand too that even if you got back to normal, you would still have to maintain good control or would be back where you started.

I thought before once at the type 2 stage you couldn't move backwards into anothe category (if thats the right word)🙂

 

[Northerner]

I agree, reversal is a very bad term to use. It is possible for many people to improve their blood sugar levels by improving their insulin sensitivity - making appropriate changes to diet and lifestyle - but this is not possible for many more who, despite their best efforts, may have to continue with medication and eventually increase it. These latter people may feel they have failed if they are unable to 'reverse' their diabetes, but it may be something completely beyond their control.

 

[chrismbee]

Lucy, as Dodger and margie have explained, it's not about reversing diabetes, as there is no cure. It's to do with improving the body's ability to process sugar, mainly through decreased insulin resistance - a significant factor in T2 diabetes. You are right to assume that, having been diagnosed, one will always be at higher risk of the condition progressing in the future, hence the emphasis on maintaining a healthy lifestyle and diet. Gestational diabetes frequently all but disappears after birth, but the long term risks remain.

The power of the English language can also be its downfall, in that using the term reversal may be perfectly apt, in the context in which it was intended. However, the meaning may be understood in different ways. This very fact is often used to great advantage by the media, when condensing original statements into bite-size headlines.

 

[lucy123]

Thanks all, but can you still help with whether a type 2 can through good control move backwards along the so called curve to become glucose intolerant and even further back to become normal as long as maintaining good control.

Sorry if you have already explained this and I have missed it - it is Friday!🙂

 

[chrismbee]

If, by "normal", you mean that you can eat any old rubbish and expect your body to deal with it, as if you didn't have diabetes, then the answer is no.
You can enjoy normal BG's, provided that you maintain the healthy eating/life plan.
In essence, the diet/exercise plan is your "medication".
Does this make sense?

 

[novorapidboi26]

I think if its diagnosed quickly, and the diet and lifestyle also changes quickly then the a life free of medication and elevated risks probably could be achieved.......

But with type 2 its often diagnosed much later and so the beta cells have already went through the stresses of supplying more insulin and therefore may start to slowly degrade and therefore the never be able to secrete the insulin normally.....

But I may just be talking rubbish............

 

[MargB]

I also received the email and had to read the article closely to pick up the section that kind of said it was not a cure.

It is confusing as they seem to say you are only type 2 if you take medication but what about all the type 2s who are currently controlling things by diet and exercise? I can understand someone who is pre-diabetic is able to ward it off but they have been warned and need to control what they are doing.

 

[donnarob]

Hi There,

Define good control?

Fasting b/g this morning was 6.5

For breakfast, I had a slice of rye bread with a couple of slices of Jarlsberg cheese. 1 hour later I was 8.4

2 hrs later I was 6.2

3 hrs later I'm now at 5.4

About to have some lunch which will be warm roasted breast of chicken with a Greek salad followed by some fruit.

Will have some nuts or something around 4pm and will probably have something like lamb curry and spiced rice for dinner. Is this good control?

Yesterday afternoon I went as low as 4.1 but I kept reminding myself, this is good control - as almost in the "normal" range. In fact my family were all higher than me and they aren't diabetic? This can be so confusing at times.

Diabetes is a constant reminder of that the disease won't reverse itself but you can turn things around to benefit your overall health. By ditching out the crap from your diet, you can get there and, to my absolute joy, I can eat chocolate albeit very dark high cocoa solids!!

Probably, if you grab diabetes by the b***s, you will become healthier and have a much healthier diet in the long run.

Hope everyone has a lovely weekend.

Donna
Donna :🙂

 

[everydayupsanddowns]

Even the most optimistic posts I've read here from T2s who have been able to control their BG levels with careful management of diet, weight and activity have been very cautious about their current 'stability'. There are those who have been approaching insulin, but have managed to gradually reduce oral meds and then seem to be able to control levels with diet and exercise.

Wallycorker (who I've not seen around here for some time) even cautiously suggested that it seemed like he could now 'get away' with occasionally eating carbs which would have previously been difficult, wondering perhaps whether loss of fat around organs was allowing things to work a little more again.

But this is always 'once in a while' and the posters seem fairly clear that if they just went back to eating any old thing they are pretty sure the D would come back with a vengeance.

And there are many others for whom no amount of abstinence and self-control seems able to let their body cope without medication.

Diabetes is a frustratingly fickle and varied beast. YDMV.

 

[chrismbee]

A medical condition is determined by the state of the body and its processes - not by the medication used to treat it.

Diabetes relates to the body's ability to process sugar from the blood into the cells.

Due to a variety of influencing factors, effective treatment can vary from control of diet alone, to taking medication. The form of medication depends on the factors that are causing the sugar absorption issues and can range from tackling insulin resistance to giving additional insulin to supplement your body's own requirements.

Perhaps, rather than using terms like "reversing diabetes", it would be more appropriate to consider "reversal of medication dependency", although this doesn't trip off the tongue as easily, and certainly doesn't make a "good" headline.

 

[novorapidboi26]

Hi There,

Define good control?

This morning I had a slice of rye bread with a couple of slices of Jarlsberg cheese. 1 hour later I was 8.4

2 hrs later I was 6.2

3 hrs later I'm now at 5.4

About to have some lunch so is this good control?

Yesterday afternoon I went as low as 4.1 but I kept reminding myself, this is good control - isn't it?

My main concern is that when I go as low as 4.1, I've realised I haven't eaten enough carbs, so could afford to have some rice or something carby with my evening meal.

Donna :🙂

That is good control, all that is different to a non diabetic is the 8.4 after your food, this is normal for a diabetic though....

4.1 is on the lower end of the normal range, but still OK, as your type 2 your pancreas should hold back the insulin at this point..........

I tested my 2 year old 2hours after tea and he was 4.2, I was 5.6.....🙂

 

[mcdonagh47]

Thanks all, but can you still help with whether a type 2 can through good control move backwards along the so called curve to become glucose intolerant and even further back to become normal as long as maintaining good control.

No. When you are dxed Type 2 Diabetes you have passed the point of no return.

_____________________________________________________________
"All is changed ,changed utterly, a terrible new beauty is born". W.B. Yeats

 

[cazscot]

By healthy eating/exercise some people can "reverse" their symptoms. Me being an example. Through loosing weight I have come off all my medication and my latest HBA1C was 5.5 which is a "normal" persons range, if you redone all my tests just now you wouldn't be able to tell I was diabetic and I would come out as normal but that doesn't mean I am cured just that I have managed to get my diabetes under control (at the moment)...

So in answer to your question Lucy - yes it is possible for some people to move backwards...

 

[mcdonagh47]

By healthy eating/exercise some people can "reverse" their symptoms. Me being an example. Through loosing weight I have come off all my medication and my latest HBA1C was 5.5 which is a "normal" persons range, if you redone all my tests just now you wouldn't be able to tell I was diabetic and I would come out as normal ..

No you wouldn't - if you took an OGTT now you would come out as a Type 2 Diabetic.
By losing the weight ( although its the right thing to do )you are simply masking t2 not reversing it or going backwards. When you reach your ideal weight the real struggle will probably begin.

 

[lucy123]

I am not too sure I agree with that. I have just spoke with my consultant regarding other things and raised this question.

He confirmed as Cazscot says that you can move back as far as normal range and have a normal ogtt if your control is good - but as soon as you eat a doughnut for example you would be on your way very quickly back to t2 range. I am not saying you stop being a t2, but you reverse your symptoms back to normal as long as you are good. Surely if your control is that good that your levels are coming out as normal (as Cazscots are) then that has to be great progress?🙂

 

[chrismbee]

When you reach your ideal weight the real struggle will probably begin.

Sorry mcd, don't follow
Surely, on achieving a medically-good weight (for your height/frame/gender/age etc.) your diabetes treatment becomes easier, more straightforward?
Let us not forget that achieving a good weight helps in so many areas - hardly the beginning of "real struggles"

 

[HelenM]

I think that if the diabetes is diagnosed early enough in the process...and it is a linear process, then some people may be able to stop the process in it's tracks. However, they would still have a tendency to become glucose intolerant and stopping the healthy eating regime, or being unable to continue the same amount of activity might cause more insulin resistance again.
Unfortunately by the time some people are diagnosed the process has been going on for some time with some loss of beta cell function so they may not be able to 'reverse' their condition. Also, not all people labelled as T2 are overweight, and perhaps there are several variants of T2, some more likely to respond well to diet and exercise than others

Here's a simple report in a Diabetes Journal, they use the word reversal here:

Reversal of Type 2 diabetes in the context of bariatric surgery is currently of great interest. Discussion of the rapid and dramatic effects of bariatric surgery upon the pathophysiology of Type 2 diabetes has concentrated almost exclusively on surgically induced change in the incretin hormones [1,2]. Little consideration has been given to reversal of Type 2 diabetes by the effects of caloric restriction alone. We report a person with Type 2 diabetes who returned to normal fasting blood glucose and glycated haemoglobin (HbA1c) after reading a notice about a grant award in Balance concerning the effects of a hypocaloric diet on glucose control

Dietary reversal of Type 2 diabetes motivated by research knowledge

http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2010.02992.x/full
Actually the full story isn't so different to some we read on diabetes forums.The lady lost weight, fasting glucose and HbA1c came down. We don't know about an OGTT


One study back in in 1982 looked at the treatment of T2 on diagnosis by diet alone and did do another OGTT.The subjects were put onto a diet varying between 1000 and 1800 calories a day (individualised according to weight, gender actiivity levels etc) 40% of the diet was carbs.
After 3 months they had another OGTT. Of the 182 patients studied,
25.4% average improvement in glucose tolerance,
37 subjects "became well-controlled in that the area under the glucose response curve after treatment became normal
"29 subjects " were poorly-controlled as the area under their glucose response curves remained at least twice the upper limit of normal.'.

."Those patients whose glucose tolerance became normal were mainly men, and were significantly heavier and had significantly less glucose intolerance before treatment than those patients who remained poorly controlled. On diet therapy the well-controlled patients lost more weight and showed a significantly greater fall in plasma triglyceride levels."

Did those people sustain their 'normal' glucose tolerance status? We don't know. One thing is clear is that the researchers' invested a lot of time and effort in teaching and supporting people in their diets, they weren't just given an instruction sheet to take away with them.
Treatment of Type 2 (Non-Insulin-Dependent) Diabetic Patients with Diet Alone
http://www.springerlink.com/content/l64x431508p21739/fulltext.pdf

Another paper here is far too detailed to summarise. It also suggests that reversal is possible by diet in early diagnosed cases of T2.
Pathogenesis of type 2 diabetes: tracing the reverse route from cure to cause
http://www.springerlink.com/content/j088876181l3qu55/fulltext.pdf

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