I am in remission??!

[Trishbethel]

Hi all,

I just had my 3 month review, from being diagnosed (it's actually 6 months since first blood test) and my new HB1ac is 42! Am so chuffed as have worked so hard, and have been worrying about having had some blow out days etc over the 3 months and what effect they would have on my results, and am so very pleased to know all my hard work has paid off!
But the nurse told me I am in remission, that I am still insulin resistant and still have diabetes, but that my numbers are now in normal perimeters so I am now classed as in remission? I've heard mixed views on this, is there such a thing as remission, my nurse friend says no?! I always feel like one high is taken away with another conflict in opinion

Trish

 

[NoCrbs4Me]

I think it is possible to be in remission / cure / reverse type 2 diabetes. You can have normal blood glucose, but still have insulin resistance that results in elevated insulin levels. Unfortunately, the only way to know for sure that you don't have any insulin resistance is to get your insulin levels measured, which I doubt the government will pay for. There are surrogate markers that indicate that you're no longer insulin resistance (e.g. low triglycerides, high HDL, and other blood tests).

However, the best thing to do when you've achieved non-diabetic blood glucose levels is to carry on doing what got you there. Being in remission doesn't mean you can go back to eating the way you used to.

I'd have asked the nurse how she knows you still have insulin resistance.

And congratulations!

 

[Freema]

it is a question of definition... dont know if there really is an official definition of remision ...we are still diabetic even when being in the normal area for blood glucose ... being in full remission like cured would mean that we could again eat loads of sugar and pizzaes and alike without spiking very much... , but that said being able to control diabetes that well would maybe mean that you wont get all these adding horrible diseases .. and that is the most important , be proud of yourself and keep on doing the great work you are doing, maybe you can get even lower in HbA1c ..

 

[Rachox]

Well done on your result. I agree with the other commentators. My recent HbA1c was in the non diabetic range. I don't consider myself cured, in remission or any other term which implies I'm diabetes free. My GP described me as having well controlled diabetes. My low carb lifestyle is for life, hopefully a life free of diabetes complications.

 

[Guzzler]

Well done on your Magic42 success. I, too, think that reversal and remission are words that we have to be careful about using as they can suggest something akin to cured. There is no cure, once diabetic always diabetic. We will always have to be aware of our diet and woe betide us if we become complacent.
What you have achieved is the vastly reduced risk of diabetic complications which is no small thing so you can congratulate yourself on a job well done. Go on, treat yourself!

 

[kokhongw]

These 2 graphs may give a more complete picture of where we stand when we are in remission. We have moved back the progression of our condition with the improved/normal glucose level...but typically have not restored normal glucose AND insulin responses.

http://www.ejinme.com/article/S0953-6205(09)00098-3/fulltext

In terms of improvements in our insulin responses, we have likely moved from the Red curve to the Orange or even Yellow curve. Very few ever return to the cool Blue curve.

https://intensivedietarymanagement.com/understanding-joseph-kraft-diabetes-in-situ-t2d-24/

 

[pleinster]

Hi all,

I just had my 3 month review, from being diagnosed (it's actually 6 months since first blood test) and my new HB1ac is 42! Am so chuffed as have worked so hard, and have been worrying about having had some blow out days etc over the 3 months and what effect they would have on my results, and am so very pleased to know all my hard work has paid off!
But the nurse told me I am in remission, that I am still insulin resistant and still have diabetes, but that my numbers are now in normal perimeters so I am now classed as in remission? I've heard mixed views on this, is there such a thing as remission, my nurse friend says no?! I always feel like one high is taken away with another conflict in opinion

Trish

I think so long as it is understood that being in remission includes the very strong likelihood/certainty that blood sugar levels would go up again if you are not on any meds and increase the carbohydrate intake to a level which changes the game again...it is fair to say you are in remission. I like the way the diabetes consultant I see expressed the position on seeing that my HbA1c had dropped down to 41 purely through diet alone (ie. LCHF), when he said I was "effectively in remission".

By the way - WELL DONE !

 

[NoCrbs4Me]

I wonder what your consultants considers to be the difference between "effectively in remission" and "in remission"?

 

[pleinster]

I wonder what your consultants considers to be the difference between "effectively in remission" and "in remission"?

I think he just wanted to place a little emphasis on the need to maintain a certain approach as for quite number of people the term "remission" like"reversed" is interpreted as implying some permanency (ie. that everything is totally fine and can be put out of mind). I agree. I personally interpret it as meaning...to all intents and purposes in remission so long as the effective approach is maintained, but I recognise that its all about how we use words and what we attach to them in terms of meaning. Ultimately...these are just words.

 

[Biggles2]

Here is a link to a good article: http://www.practicaldiabetes.com/article/diabetes_in_remission/

 

[AM1874]

Hi @Trishbethel ..
Remission, reversal whatever .. well done and many congrats on your excellent HbA1c
As @NoCrbs4Me and others have said, though, you now need to just keep on doing whatever you have been doing

 

[Anthony1738]

Absolutely Great Thread, so heres my question, (my current numbers are below in my signature), a couple of days ago I went to my Fridge and discovered I still had one potatoe (medium sized White) so I decided to have this baked with Cheese and Baked beans, knowing full well it had a chance that it would spike my BG. So 2 hours after the first bite my reading was 7.7, High but not to bad, 1 hour later my reading dropped back to 5.7, thats a big drop in 60 mins, and in the morning my FSB was 5.7. Am I in remission?

 

[Trishbethel]

Thanks everyone, I think like many have said remission or not, it's a great result, and yes I must keep on doing as I have thus far - and need to look at it as I am holding off those nasty complications as one if you lovely people said Thank you all, love this forum, it's nice for the support and reassurance when it's needed xx

 

[CherryAA]

Absolutely Great Thread, so heres my question, (my current numbers are below in my signature), a couple of days ago I went to my Fridge and discovered I still had one potatoe (medium sized White) so I decided to have this baked with Cheese and Baked beans, knowing full well it had a chance that it would spike my BG. So 2 hours after the first bite my reading was 7.7, High but not to bad, 1 hour later my reading dropped back to 5.7, thats a big drop in 60 mins, and in the morning my FSB was 5.7. Am I in remission?

A couple of weeks ago @bulkbiker and I did OGTT tests they showed that at the two hour mark we have glucose back to opening levels .

A recent study was published where they claimed " remission" from T2 diabetes for pre-diabetics adopting a high protein low carb diet where they had also done precisely that.

The attached picture shows. our response as two " severe " diabetics at diagnosis, compared to those in the study and to the Kraft "Normal" responses and the Kraft hyperinsulinamia response

Because today's diet is has been so full of carbs for so long the population in general now has higher insulin responses than historically, so in order to compare what our figures were with someone " normal" today, a 28 year old none diabetic friend who has been low carbing (ish) for a few month also joined in.

@bulkbiker biker is one of the most successful people here in terms of weight loss and Hba1c.

Looking at this data I would say none of us are " in remission" all of us are " well controlled".

 

[Biggles2]

Absolutely Great Thread, so heres my question, (my current numbers are below in my signature), a couple of days ago I went to my Fridge and discovered I still had one potatoe (medium sized White) so I decided to have this baked with Cheese and Baked beans, knowing full well it had a chance that it would spike my BG. So 2 hours after the first bite my reading was 7.7, High but not to bad, 1 hour later my reading dropped back to 5.7, thats a big drop in 60 mins, and in the morning my FSB was 5.7. Am I in remission?

@Anthony1738 firstly, the results in your signature are stellar! Absolutely wonderful job! With regard to remission, there is scant information in the literature, where remission continues to be seen as very rare indeed. That said, there are formal definitions of partial remission, complete remission and prolonged remission. As you will see, to meet the formal medical definition of remission, you will need to maintain specific glycemic targets over specific periods of time.

The graphic below is from the link to "Diabetes in Remission" that I posted in post #10 above. The definition in the graphic comes from the Buse et al 2009 consensus statement "How do we define cure of Diabetes?" available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768219/

 

[Bebo321]

These 2 graphs may give a more complete picture of where we stand when we are in remission. We have moved back the progression of our condition with the improved/normal glucose level...but typically have not restored normal glucose AND insulin responses.

http://www.ejinme.com/article/S0953-6205(09)00098-3/fulltext

In terms of improvements in our insulin responses, we have likely moved from the Red curve to the Orange or even Yellow curve. Very few ever return to the cool Blue curve.

https://intensivedietarymanagement.com/understanding-joseph-kraft-diabetes-in-situ-t2d-24/

I love these graphs! - especially the Kraft one. Thank you.
Just to be devil's advocate, if diabetes 'reversal' is linked to insulin resistance, (for example the red, orange and yellow curves all exist because of impaired insulin sensitivity), yet we know that insulin resistance can be improved immeasurably (take it to the extreme and say that somebody fasts and loses all excess fat from their liver and makes a dramatic change to their lifestyle). Leaving all other complicating factors aside (so potential reduced beta cell function, hormonal issues etc). Would it be possible to say that in some instances type 2 diabetes can be reversed, or are there physiological changes such that after diagnosis, it means that the body has been somehow irreparably 'altered'? (I ask, because I don't know the answer).

 

[kokhongw]

Would it be possible to say that in some instances type 2 diabetes can be reversed, or are there physiological changes such that after diagnosis, it means that the body has been somehow irreparably 'altered'?

I believe Dr Roy Taylor will be able to provide clearer answers from the update of his latest study coming up in Dec.

Personally I believe at some point there may be irreversible damage...yet our human body has amazing healing and regenerative capability. It is just that we have not figured out the correct conditions for the regeneration to occur.

Dr Valter Longo's cycles of Fasting Mimicking Diet is another possible protocol that may help to regenerate dysfunction and lost beta cells. Also looking forward to more of his studies being available next year...

 

[Anthony1738]

@Anthony1738 firstly, the results in your signature are stellar! Absolutely wonderful job! With regard to remission, there is scant information in the literature, where remission continues to be seen as very rare indeed. That said, there are formal definitions of partial remission, complete remission and prolonged remission. As you will see, to meet the formal medical definition of remission, you will need to maintain specific glycemic targets over specific periods of time.

The graphic below is from the link to "Diabetes in Remission" that I posted in post #10 above. The definition in the graphic comes from the Buse et al 2009 consensus statement "How do we define cure of Diabetes?" available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768219/

Thank you for your replies, looks like we need a lot more studies with a lot more people following a LCHF diet with fasting, to prove these "curability" factors, I myself am testing, and trying different things and I'm sure so far that type 2 can be cured, and its not the death sentence that GPs describe right now

 

[KathyCP]

The graphic below is from the link to "Diabetes in Remission" that I posted in post #10 above. The definition in the graphic comes from the Buse et al 2009 consensus statement "How do we define cure of Diabetes?" available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768219/

ummm ... no mention of diet, so i guess it's possible to be classed as being in some stage of remission but still not be able to eat a 'normal' diet (i.e. pizza and sugar) without consequences - unless of course you define a lchf diet as an 'ongoing procedure' - which personally, i wouldn't.

 

[veggirl]

Well I got down to 10stone 4lbs (was 14stone). Hba1c 35 (was66) Low carbing worked but have fallen off wagon, now 11stone 6lbs and hba1c 46. So was in remission but only if I keep the weight off and stay low carb. I now am aiming to lose 2 stone and try to stay low carb again but I do find it hard . There really is no substitute for bread.