What is remission/reversal of type 2?

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Sussexmax

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Type 2
This might seem an obvious thing, but I have read different interpretations and I wondered which is correct…

Some say that it is lowering BG to ‘normal’ levels without any medication, whereas others suggest it is simply bringing it down to that level - even if still taking meds.

Also, is it true that as I’ve now been diagnosed as ‘diabetic’ that will always remain with me, even if I manage to get my levels back into the normal range?

Still coming to terms with the diagnosis, and trying to understand the situation and the challenge ahead!
 
Sussexmax said:
This might seem an obvious thing, but I have read different interpretations and I wondered which is correct…

Some say that it is lowering BG to ‘normal’ levels without any medication, whereas others suggest it is simply bringing it down to that level - even if still taking meds.

Also, is it true that as I’ve now been diagnosed as ‘diabetic’ that will always remain with me, even if I manage to get my levels back into the normal range?

Still coming to terms with the diagnosis, and trying to understand the situation and the challenge ahead!
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I don't think the definition really matters.
I reversed mine, and can eat a normal diet.

Another definition is having a normal Hba1c, without using medication.
So diet control is acceptable under that definition.

For insurance and similar I still declare I am diabetic, to avoid any argument if I need emergency treatment, as being diabetic in the past is always going to be on my record, and it's going to be down to the insurer to accept diet control, or me to proven I don't, and I don't want that in A&E.
 
Sussexmax said:
This might seem an obvious thing, but I have read different interpretations and I wondered which is correct…

Some say that it is lowering BG to ‘normal’ levels without any medication, whereas others suggest it is simply bringing it down to that level - even if still taking meds.

Also, is it true that as I’ve now been diagnosed as ‘diabetic’ that will always remain with me, even if I manage to get my levels back into the normal range?

Still coming to terms with the diagnosis, and trying to understand the situation and the challenge ahead!
Click to expand...

For me, personally it is having an HbA1c of under 42, without medication, and maintaining it for a period of 1+years. 48 is the diabetes diagnostic threshold, with 42 pre-diabetes, so personally, I'd prefer to stay away from those areas.

Diabetes UK says the following about remission: https://www.diabetes.org.uk/guide-t...eating-your-diabetes/type2-diabetes-remission

Just for completeness, I was diagnosed with an A1c of 73 in October 2013. By my next test, in the February, I had achieved 37 and have been lower than 37 since. I have never taken medication for diabetes.

In terms of medical records, my records state "Diabetes Resolved". I still have an (at least) annual full bloods panel, including an A1c test, and retinal screening.
 
Good question @Sussexmax and one that is debated periodically on the forum and sometimes the debate gets quite heated, so sit back and see what happens.

Personally I don't like either term because there is no real definition of either concept. Some think that reversal/remission describe the same thing and the terms are interchangeable. Others think they mean different things and others think their term is better than the other to describe the same thing. Guaranteed to cause really rather pointless debate on a forum.

At the end of the day we are all aiming to control blood glucose to levels which will not result in long term harm. There are different ways to get there and different strategies to make sure you stay there and some people are more successful than others in finishing up with the level of control they are looking for. If you get to that position it really does not matter what you call it. Reversal, remission, control, hunkydoryness.... take your pick. Only thing i will guarantee is that somebody will tell you that you are wrong.
 
For my own personal take on it - for me only - Remission means under 42 without medication simply because at 42 I would then be Pre-Diabetic which would signal Insulin Resistance and not an ideal trend upwards…

I prefer Remission as opposed to Reversal…

In terms of ‘Once Diabetic Always A Diabetic’ I’m ok with that - keeps me on my toes and I still get free eye tests, flu jabs etc etc, so it has its benefits 😉

Yep, it’s a hot topic alright, and the true definition as it stands certainly gets heated discussions at times!
 
Sussexmax said:
This might seem an obvious thing, but I have read different interpretations and I wondered which is correct…

Some say that it is lowering BG to ‘normal’ levels without any medication, whereas others suggest it is simply bringing it down to that level - even if still taking meds.

Also, is it true that as I’ve now been diagnosed as ‘diabetic’ that will always remain with me, even if I manage to get my levels back into the normal range?

Still coming to terms with the diagnosis, and trying to understand the situation and the challenge ahead!
Click to expand...
I too am confused, diagnosed in May this year with a HbA1c of 50 as T2. In September I had my first bloods done since diagnosis, and asked why I had been added to diabetic register after only one reading in diabetic range, as my understanding was that NICE suggested especially for those just in the range should have 2 tests before being added.

Result of that test 44 2nd test after diagnosis 13th December received results by text from DSN at surgery your HbA1c is now 43 and has been non diabetic for 6 months which means your diabetes is in remission, and from now you will have annual tests. My follow up appointment with her is in January earliest available after test.

So am I in remission or pre diabetic?
I know I will need to be careful with my diet, and keep an eye on my levels, I'm still using my BG monitor and will continue to do so.

My point is, I guess, that the information sometimes conflicts and causes confusion, and all I can do is my best, and remain motivated to watch my diet, exercise and keep a close eye on my BG's.
 
Wannie said:
So am I in remission or pre diabetic?
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If the message says "in remission" I guess you're in remission. It surely makes sense to have the annual tests anyway, just in case so it probably doesn't matter much. Maybe in places where you need to declare preexisting conditions (like travel health insurance) there's some question?
 
Docb said:
Good question @Sussexmax and one that is debated periodically on the forum and sometimes the debate gets quite heated, so sit back and see what happens.

Personally I don't like either term because there is no real definition of either concept. Some think that reversal/remission describe the same thing and the terms are interchangeable. Others think they mean different things and others think their term is better than the other to describe the same thing. Guaranteed to cause really rather pointless debate on a forum.

At the end of the day we are all aiming to control blood glucose to levels which will not result in long term harm. There are different ways to get there and different strategies to make sure you stay there and some people are more successful than others in finishing up with the level of control they are looking for. If you get to that position it really does not matter what you call it. Reversal, remission, control, hunkydoryness.... take your pick. Only thing i will guarantee is that somebody will tell you that you are wrong.
Click to expand...
Sorry, I didn’t mean to disturb a hornet’s nest!
 
Bruce Stephens said:
If the message says "in remission" I guess you're in remission. It surely makes sense to have the annual tests anyway, just in case so it probably doesn't matter much. Maybe in places where you need to declare preexisting conditions (like travel health insurance) there's some question?
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When I attend my follow up appointment in January I will be asking firmly but politely for diabetic bloods to be done in May, 12 months from diagnosis and after that result I may be happy to have it done annually.
My own thoughts were that they were in too much of a rush to put me on the diabetic register, but whats done is done. And I'm now over 3 stone lighter and 3 dress sizes smaller!:rofl:
 
Bruce Stephens said:
If the message says "in remission" I guess you're in remission. It surely makes sense to have the annual tests anyway, just in case so it probably doesn't matter much. Maybe in places where you need to declare preexisting conditions (like travel health insurance) there's some question?
Click to expand...
Technically, there isn't a "diabetic register".
Just the option to be invited for annual screening, and checks as required.
I'd way rather be invited back, than cut loose.

As to insurance, any cost to my annual travel policy works out roughly £5 a month last year.
I pay for a private specialist doctors report to continue diving.
It's an honesty tick box on the dive sheet though, I could ignore it, but I feel the extra check up is money well spent, as the test a lot more than my diabetic review covers, it is a full commercial diver health report.
 
Wannie said:
When I attend my follow up appointment in January I will be asking firmly but politely for diabetic bloods to be done in May, 12 months from diagnosis and after that result I may be happy to have it done annually.
My own thoughts were that they were in too much of a rush to put me on the diabetic register, but whats done is done. And I'm now over 3 stone lighter and 3 dress sizes smaller!:rofl:
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Well done, that’s fantastic to lose 3 stone and I’m sure you were delighted to buy a new slimmer wardrobe! That’s what I’m looking forward to!! Brilliant to do that without medication.

I know what you mean about the hurry to be classified as diabetic, but as others have said the benefits of being checked regularly outweigh that anyway.
 
The good thing is, once diabetic, even if in remission you will be monitored and have you bloods tested and all the other checks so that means you will get the best care and be able to deal with any issues along the way, I see it as a positive, its just a name and doesnt define you, I am still me, I wouldnt say I am a diabetic, I would say I am Jenny and always will be x
 
Wannie said:
I too am confused, diagnosed in May this year with a HbA1c of 50 as T2. In September I had my first bloods done since diagnosis, and asked why I had been added to diabetic register after only one reading in diabetic range, as my understanding was that NICE suggested especially for those just in the range should have 2 tests before being added.

Result of that test 44 2nd test after diagnosis 13th December received results by text from DSN at surgery your HbA1c is now 43 and has been non diabetic for 6 months which means your diabetes is in remission, and from now you will have annual tests. My follow up appointment with her is in January earliest available after test.

So am I in remission or pre diabetic?
I know I will need to be careful with my diet, and keep an eye on my levels, I'm still using my BG monitor and will continue to do so.

My point is, I guess, that the information sometimes conflicts and causes confusion, and all I can do is my best, and remain motivated to watch my diet, exercise and keep a close eye on my BG's.
Click to expand...
Not sure where this "annual review" comes from as NICE recommends 6 monthly tests once diagnosed.

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk www.nice.org.uk

Section 1.61
I admit I had to remind my surgery of this (and join the PPG) but now get semi annual tests even though in remission for almost 7 years.
 
Sussexmax said:
Well done, that’s fantastic to lose 3 stone and I’m sure you were delighted to buy a new slimmer wardrobe! That’s what I’m looking forward to!! Brilliant to do that without medication.

I know what you mean about the hurry to be classified as diabetic, but as others have said the benefits of being checked regularly outweigh that anyway.
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Thank you and I am happy to have the checks done, I was agreeing with you that information is conflicting and confusing and I just have a little niggling concern that 'they' were quick to classify me as a diabetic and seem to be quick to say I'm now in remission.
 
Jenny65 said:
The good thing is, once diabetic, even if in remission you will be monitored and have you bloods tested and all the other checks so that means you will get the best care and be able to deal with any issues along the way, I see it as a positive, its just a name and doesnt define you, I am still me, I wouldnt say I am a diabetic, I would say I am Jenny and always will be x
Click to expand...
Happy to be monitored and checked, I was agreeing with @Sussexmax that the information can be conflicting and is confusing.

I don't think diabetes or anything else defines me, like you, I am me always have been and always will be! 🙂
 
bulkbiker said:
Not sure where this "annual review" comes from as NICE recommends 6 monthly tests once diagnosed.

Recommendations | Type 2 diabetes in adults: management | Guidance | NICE

www.nice.org.uk www.nice.org.uk

Section 1.61
I admit I had to remind my surgery of this (and join the PPG) but now get semi annual tests even though in remission for almost 7 years.
Click to expand...
Section 1.2.1

Section 1.6.1 is just a HbA1c check. That seems a bit pointless on it's own.
Although all my surgeries have done full bloods more often if I ask to be fair to them.
 
travellor said:
That seems a bit pointless on it's own.
Click to expand...
It's a lot better to get two a year than one..especially if you want to monitor the situation.
 
To be personally, remission would mean being able to eat carbohydrates without being careful about amount and fat to slow release etc, and not spike BG more than a never-diabetic person. If non-diabetic numbers including HbA1c are only achievable by restricting diet then to me that is "diet controlled diabetes" not remission. Which is absolutely fantastic but just not the same thing to me.

I base that understanding on the use of remission when talking about cancer - it does not exclude the possibility of it returning, but means that at that time you are completely clear as far as can be seen on the tests.

I have lost 15kg since diagnosis and 20kg since the highest weight I recorded earlier this year, and in general my BG readings have been good and I am expecting my next HbA1c to be below diabetic level and hoping for below 42. But I can still see post meal spikes above 3 mmol sometimes from relatively low carbohydrate meals if they are also very low in fat, so I don't think that I have achieved remission.

(Edited to add - by post meal I meant 2 hours post meal. It isn't clear to me from some of the responses if everyone realised that was what I meant.)
 
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I am aware that I will have to eat like this forever, but I am actually having lovely meals whereas previously I woulf often just snack on and off through the day, I feel satisfied and never hungry anymore. I do have a few carbs but stick to under 130g and 1200 calories each day which is managable.

Today I had greek yoghurt and frozen cherries for breakfast, shepherds pie with carrots cauliflower and brocolli for lunch and for dinner Ham salad. Previously a typical day would be skip breakfast and then be so hungry by 11, eat a couple of rounds of cheese and salad cream sandwiches and a packet of crisps, maybe a chocolate bar. I would drink coke zero, coffee or tea and never just water, I would pop out for several cigarettes in a day (smoked about 10 a day), I would then graze a little between lunch and dinner, on cheese, bread, cake, sausage rolls etc, basically whatever I fancied, I would sometimes not eat dinner but go down at 11pm and make a huge bowl of pasta with cheese and sauce or 4 rounds of toast with marmalade or jam. I just added a typical eating day onto my app out of interest and I would eat 4289 calories and 485g of carbs on a typical day, but even then I was always hungry! Now I eat vegetables and proper meals with reduced carbs and no longer feel hungry at all, it was the snacking that got me, so I think I should be able to tolerate normal food but what I ate before was anything but normal. I would have 4 rounds of thickly buttered toast, loads of pasta with cheese and loads of salad cream in my sandwiches. I feel sick thinking about the volume of things I ate before.
 
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