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Remission is good but is DT2 reversible ever?

ianf0ster said:
Remission from Type 2 Diabetes is certainly possible by using lifestyle (even without any drugs and without any additional exercise). I'm one of over a thousand people in the UK have achieved this (as have tens of thousands worldwide).
Cure implies that if you will still be OK if you then start eating the garbage that made you Type 2 diabetic in the first place. To me this just sounds highly unlikely to happen and also something that any sensible person wouldn't even try!
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May I ask where you found the figure of a thousand folks in UK in remission, please?
 
Oldvatr said:
Whatever the definition. the NHS is now rolling it out big time for T2D who happen to be overweight and in England.
www.england.nhs.uk

NHS England » NHS Type 2 Diabetes Path to Remission Programme

The NHS Type 2 Diabetes Path to Remission Programme is a joint initiative between NHS England and Diabetes UK available to eligible people in England. This programme provides a low calorie, total diet replacement treatment for people who are living with type 2 diabetes and obesity or overweight...
www.england.nhs.uk www.england.nhs.uk
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You need to have something you can pin a payment to. I expect that in the next few years there will be a QoF figure linked to "numbers / percentages of T2 patients achieving remission". One payment for finding >48 HbA1cs, and a further payment for subsequent <48 HbA1cs.
 
Glyko said:
What does the science say about type 2 diabetes reversal?

I read that reduced fat in the liver and pancreas can reduce insulinresistance and make your t2 improve? I've scrolled NCBI/medline but I'd like to get your views and experiences.
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Like all things, I believe the devil is in the detail and definitions do matter of course.

It is only relatively recently that there has been an internationally agreed definition of Remission: https://link.springer.com/article/10.1007/s00125-021-05542-z

In the US, there has been a longer held position of definitions on a sliding scale, resulting in remission for 5 years+ being referred to as a Functional Cure. That said a quick look today doesn't return me any information on that today, so it could be the US has aligned with other countries. I don't know.

Personally, I think the agree definition is a bit relaxed, but the bar has to be set somewhere. Again personally, I have been in remission over 9 years, and consider my modified eating regime and other self-management techniques have become part of my normal day to day activities, so very repeatable, moving forward.

Of course, things can change in the future, but for now, I am content ploughing my personal furrow. Should things change, I'll just have to handle it in the best way I can.
 
AndBreathe said:
Like all things, I believe the devil is in the detail and definitions do matter of course.

It is only relatively recently that there has been an internationally agreed definition of Remission: https://link.springer.com/article/10.1007/s00125-021-05542-z

In the US, there has been a longer held position of definitions on a sliding scale, resulting in remission for 5 years+ being referred to as a Functional Cure. That said a quick look today doesn't return me any information on that today, so it could be the US has aligned with other countries. I don't know.

Personally, I think the agree definition is a bit relaxed, but the bar has to be set somewhere. Again personally, I have been in remission over 9 years, and consider my modified eating regime and other self-management techniques have become part of my normal day to day activities, so very repeatable, moving forward.

Of course, things can change in the future, but for now, I am content ploughing my personal furrow. Should things change, I'll just have to handle it in the best way I can.
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You are not alone in that 5 years defintion

Diabetes Reversal is a Reality | Dr Mohan's Diabetes Specialty Centre

Diabetes Reversal is a Reality, There is no cure for diabetes as such, but the disorder can go into a remission phase. Remission is when blood glucose levels return to within the normal range even without the use of medications
drmohans.com drmohans.com

See Ref [2] of that article for who is giving that definition and when.
 
FYI. comparing the other path to remission that is currently being offered by the NHS, which is invasive surgery

Diabetes remission after bariatric surgery - PMC

Over the last decade, obesity rates have continued to rise in the United States as well as worldwide and are showing no signs of slowing down. This rise is in parallel with the increasing rates of type 2 diabetes mellitus (T2DM). Given the ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov


I for one will neither benefit from surgery nor the ultra low calorie path since I do not have weight to lose. My only hope so far seems to be low carb diet as my BMI is 21, and I am TOFI. My pancreas is still producing insulin. I have given up most of my diabetes meds, and could give up the remainder by tightening up my dietary intake, but I choose to use a minimum dose to support me at current levels.

From memory it seems that the DIRECT2 study showed that only something like 7% of the original intake that followed the diet plan actually could claim Remission at the subsequent follow up.
 
Zeenia said:
Hi! Did you get any treatment for retinopathy? Was there any bleeding? And do you see clearly now? How is your vision? Thanks
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Greetings @Zeenia

I went for the scheduled eye scan about 3 months after diagnosis then I received a letter to tell me I had Background Retinopathy in one eye.
A detailed report gets sent to your GP, the surgery nurse told me a R1 & R2 was detected in one eye, these were microaneurysms & were nothing to worry about.
Of course I worried but kept on my journey of remission.
The last 3 years have come back all clear, long vision perfect, need readers now but I guess that's just age.
 
KennyA said:
You need to have something you can pin a payment to. I expect that in the next few years there will be a QoF figure linked to "numbers / percentages of T2 patients achieving remission". One payment for finding >48 HbA1cs, and a further payment for subsequent <48 HbA1cs.
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I wonder how, if this were to happen, it would affect the present practice of trying to push statins?
 
KennyA said:
You need to have something you can pin a payment to. I expect that in the next few years there will be a QoF figure linked to "numbers / percentages of T2 patients achieving remission". One payment for finding >48 HbA1cs, and a further payment for subsequent <48 HbA1cs.
Click to expand...
<48 HbA1cs are easy to find now, just by running a query on their databases, but I know what you mean.

I can't say anything much about a couple of pieces of research I am involved in, but there is a great deal of interest in at least one corner of the research world in trying to work out what remission really means, and what benefits there are (aside from the blindingly obvious!) to encouraging remission.

It seems utterly insane to me that clinicians are rewarded for treating a condition, but not for the quality of their outcomes.

I'm off to a meeting tomorrow where I fear I may find it hard to keep my jaw from the table, but I'll keep trying to have a mind wider open than my mouth!
 
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