Remission / medication yes / no

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Silvershuggs

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Type 2
Hello!

I’m new to the group. I have been in remission for the past 8 months. I have a question - those on the forum who are in remission are you continuing with medication? My G.P. and diabetic nurse are insistent that I continue to take it because they say it will return if I don’t. What’s everyone else’s opinion on this or advice did their diabetic nurse or G.P. give?

Thanks for reading.
 
Silvershuggs said:
Hello!

I’m new to the group. I have been in remission for the past 8 months. I have a question - those on the forum who are in remission are you continuing with medication? My G.P. and diabetic nurse are insistent that I continue to take it because they say it will return if I don’t. What’s everyone else’s opinion on this or advice did their diabetic nurse or G.P. give?

Thanks for reading.
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If you're still taking meds then technically your diabetes isn't in remission per the current definition, so the view of your GP and DN seems a little odd. I've been in remission for over 4 years and haven't taken any meds during that time, having been told by my DN that I didn't need to.
 
Silvershuggs said:
Hello!

I’m new to the group. I have been in remission for the past 8 months. I have a question - those on the forum who are in remission are you continuing with medication? My G.P. and diabetic nurse are insistent that I continue to take it because they say it will return if I don’t. What’s everyone else’s opinion on this or advice did their diabetic nurse or G.P. give?

Thanks for reading.
Click to expand...
If you’re taking medication then no you’re not in remission. If medical professionals are advising you to continue the medication and you aren’t having adverse effects then I’d continue with it.
 
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Martin.A said:
If you're still taking meds then technically your diabetes isn't in remission per the current definition, so the view of your GP and DN seems a little odd. I've been in remission for over 4 years and haven't taken any meds during that time, having been told by my DN that I didn't need to.
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This is what I don’t understand. I was diagnosed in September 2022 and in June 2023 my level was down to 39 and then in Dec 2023 it’s now 38. They are adamant that I can’t stop the medication otherwise I’ll be back right where I started and because they have drummed it into me so much I’m anxious about trying to go without the medication. I also have to say that my diabetic nurse at the beginning told me people my age never reverse it!! So obviously, I had to prove her otherwise.
 
Silvershuggs said:
I also have to say that my diabetic nurse at the beginning told me people my age never reverse it!!
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I'm 75 so I wonder where your DN got that idea from?
 
Silvershuggs said:
This is what I don’t understand. I was diagnosed in September 2022 and in June 2023 my level was down to 39 and then in Dec 2023 it’s now 38. They are adamant that I can’t stop the medication otherwise I’ll be back right where I started and because they have drummed it into me so much I’m anxious about trying to go without the medication. I also have to say that my diabetic nurse at the beginning told me people my age never reverse it!! So obviously, I had to prove her otherwise.
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Which medications are you taking to help with your glucose management @Silvershuggs ?

Type 2 diabetes was considered to be ‘inevitably progressive’ for such a long time, and evidence surrounding the physiological mechanisms whereby remission is possible has only relatively recently emerged (so the situation is still emerging and clarifying). Perhaps your Dr or nurse have yet to really encounter medication in meaningful ways, and it makes them cautious of reducing medication.

That isn’t the case with all HCPs. The GP Dr David Unwin has made quite a thing about the proportion of his patients who have been able to come off medications.
 
Martin.A said:
If you're still taking meds then technically your diabetes isn't in remission per the current definition, so the view of your GP and DN seems a little odd. I've been in remission for over 4 years and haven't taken any meds during that time, having been told by my DN that I didn't need to.
Click to expand...
Martin.A said:
I'm 75 so I wonder where your DN got that idea from?
Click to expand...
I can only assume that despite weight loss of three and a half stone in the first nine 9 months of diagnosis they can’t decide if it was a combination of a number of things:- Familial problem, avoiding carbs and sugar, medication and losing both parents within six weeks of each other. I’ll have to review it again at the next check up and ask more awkward questions - I do like to keep them on their toes!
 
everydayupsanddowns said:
Which medications are you taking to help with your glucose management @Silvershuggs ?

Type 2 diabetes was considered to be ‘inevitably progressive’ for such a long time, and evidence surrounding the physiological mechanisms whereby remission is possible has only relatively recently emerged (so the situation is still emerging and clarifying). Perhaps your Dr or nurse have yet to really encounter medication in meaningful ways, and it makes them cautious of reducing medication.

That isn’t the case with all HCPs. The GP Dr David Unwin has made quite a thing about the proportion of his patients who have been able to come off medications.
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Thanks everydayupsanddowns.

I commenced Metformin 500mg, three times daily up until Christmas but I’m now down to 2. I think you’re right and despite having worked with lots of HCP’s I think they’re just being extra cautious.
 
I don’t have personal experience of Metformin, but based on the experiences of others, I gather that some research suggests the minimum effective dose of metformin is 1500-2000mg a day.

And that Metformin alone often only offers a small amount of support ‘in the background’. It works by reducing the amount of glucose output from the liver, and helps improve insulin sensitivity - rather than working directly on food and meals.

So I suspect (with no medical qualifications, of course) that the support you are getting from the Metformin you are taking is only a small part of your remission success?
 
hi @Silvershuggs - I was also taking metformin but could see from my daily finger pricks that my blood glucose was coming down. Although I was supposed to ramp up to 3 x 500mp per day, I discussed it with my diabetes consultant and kept it at 2 x 500mg on the basis that if my blood glucose started rising again I could go up. My GP had referred me to the consultant as my HBA1c was so high upon diagnosis and I am certain had I not been referred the GP would have said to keep up the metformin (as they even advised me to go up to 4 x 500mg before I spoke to the consultant). I think my GP was also being cautious. I have to say when I went from 2 x 500mg per day to 1 x 500mg per day there was no noticeable difference....same again when I went down to zero.
 
DiabloT2 said:
hi @Silvershuggs - I was also taking metformin but could see from my daily finger pricks that my blood glucose was coming down. Although I was supposed to ramp up to 3 x 500mp per day, I discussed it with my diabetes consultant and kept it at 2 x 500mg on the basis that if my blood glucose started rising again I could go up. My GP had referred me to the consultant as my HBA1c was so high upon diagnosis and I am certain had I not been referred the GP would have said to keep up the metformin (as they even advised me to go up to 4 x 500mg before I spoke to the consultant). I think my GP was also being cautious. I have to say when I went from 2 x 500mg per day to 1 x 500mg per day there was no noticeable difference....same again when I went down to zero.
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Hi DiabloT2

Initially he prescribed 4 x 500mg daily but it upset my stomach far too much. I think I’m going to monitor myself with blood glucose readings until then. If they rise I’ll have to increase it again but if not and my HbA1c reduces further then I’ll discuss reducing the meds down to 1 daily.
 
everydayupsanddowns said:
I don’t have personal experience of Metformin, but based on the experiences of others, I gather that some research suggests the minimum effective dose of metformin is 1500-2000mg a day.

And that Metformin alone often only offers a small amount of support ‘in the background’. It works by reducing the amount of glucose output from the liver, and helps improve insulin sensitivity - rather than working directly on food and meals.

So I suspect (with no medical qualifications, of course) that the support you are getting from the Metformin you are taking is only a small part of your remission success?
Click to expand...
I think this is the case to be honest. I would love to come off the Metformin. If reduction of HbA1c continues I will discuss reducing meds further. As well as the Metformin they also push the statins. It’s a controversial subject I know, but looking at this in depth for now, I shan’t be taking them as all my test results are extremely good.
 
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