Remission of Type 2 Diabetes for Two Years = Full Recovery of Beta-Cells

[Ronancastled]

https://diabetes.diabetesjournals.org/content/68/Supplement_1/66-OR

https://www.healio.com/endocrinology/diabetes/news/online/{544b9ed3-231a-4baa-a1e6-5874eea28e1e}/beta-cell-function-can-be-recovered-with-type-2-diabetes-remission

This piece ran in June of 2019 but I can't find any reference to it in these forums.
The main takeaway I read from this piece of Roy Taylor work is:

"Results: In the responder group, median (IQ range) maximum rate of insulin secretion increased from 0.58 (0.48 to 0.81) at baseline to 0.74 (0.54 to 1.00) at 5 months, 0.94 (0.57 to 1.24) (p=0.017 from baseline) at 12 months, and 0.94(0.64 to 1.44) (p=0.030 from baseline) nmol/min/m2 at 24 months. This was comparable to NDC (1.02(0.86 to 1.51) nmol/min/m2) by 12 (p=0.064) and 24 months (p=0.244)."

"Those who maintained remission had a higher median maximum rate of insulin secretion at 24 months which was twofold higher than at baseline.
The improved rate was comparable to that of a second cohort of age- and sex-matched participants without diabetes."

So if you de-stress your pancreas by going into remission for 2 years then your insulin secretion rate returns to to the same level as an age/sex/weight matched non-diabetic.
Now I know many of us are already over producing insulin by the time of diagnosis but it's interesting to learn that beta cells can recover/heal once the stress is removed.
Assuming the weight loss can be maintained does that only leave the condition of insulin resistance to be confronted ?

 

[ianf0ster]

OK, From tour question I assume that you are a Type 2.
If you can lower your Blood Glucose spikes and get your HbA1C into the 'normal non-diabetic range', for over a year, then it is possible for some loss of Beta Cell function to be recovered.
But there is no guarantee that this will happen in individual cases and frankly most 'in-remission' Type 2's don't care if their Beta Cells do get back to the state of the average person of their age who never had diabetes! Because all we need is for our Beta Cells to function and keep functioning well enough to process the Carbs (and the protein) in our diets.
I will probably be told off for saying most 'in-remission' Type 2's because I don't have the numbers, but with full remission rates of between 26% and 60% by using a 'Low Carb' or a Keto 'Way Of Eating' (dependent upon the cohort - from the DCUK Low Carb Program to Dr Unwin's GP Practice, to the Virta Health patient study). Note I say 'Way Of Eating' because quite a number of T2's , estimated at 10% but possibly as high as 25% of T2's were never Obese in the first place. Indeed our owm @Jim Lahey was under weight if anything, and I was at the top end of normal - just flirting with overweight.
Because we don't consume anything like the crazy amount of Carbohydrates that the Government guidelines and most GPs advise, we can get along nicely even with a moderately degraded Beta Cell function.

Is this the same for people who don't reduce Carbs and just hold their weight down through Calorie Reastyriction = starvation ? - Probably not !

 

[Ronancastled]

A fair point, if we remove the poisonous nature of carbs the temptation is there for us to put them back in our bodies again.
For those who found remission through weight loss it leads one way, back to visceral fat & square one.

I more found it interesting that at least they have proven that the pancreas can heal itself in caught early enough & the stressers are removed.

 

[bulkbiker]

I more found it interesting that at least they have proven that the pancreas can heal itself in caught early enough & the stressers are removed.

Depends if you think the pancreas was damaged in the first place or simply overwhelmed by the amount of insulin it was expected to produce. Give it a break by some fasting and not overloading the body with carbohydrate and it regains its proper function.

This can be achieved with a very low carb diet and some IF.
No need for starvation.

 

[LittleGreyCat]

<snip>

I more found it interesting that at least they have proven that the pancreas can heal itself in caught early enough & the stressers are removed.

The problem is defining "early enough".

If the pancreas is still mainly working and IR is the cause of T2 then you probably have a better chance than if the IR is lower (or absent) and the Beta cells have just started to pack up.

Sadly none of this was common knowledge 11 years or so ago when I was first diagnosed.

I do think that on first diagnosis of T2 there should be an IR and insulin production test because with up to date knowledge the treatment pathways could be different depending on the main cause.

 

[Resurgam]

I thought that for most type twos the problem was over production of insulin which is ignored - the pancreas does give up exhausted if high blood glucose levels are maintained, but I'd expect my insulin production to be normal now, as I don't see high blood glucose levels just easy weight gain.

 

[JayAmerican]

After my initial T2 diagnosis, I went to an endocrinologist to get further tests to rule out other stuff and to determine any pancreatic issues. This was an instinctive effort, I barely knew anything at the time other than to "make sure" it was indeed T2. I had no pancreas or beta cell issues and my insulin levels were normal. No kidney issues. I've likely only had high blood sugar for the past 2 years or less. Which does indeed leave me as one of those now only dealing with insulin resistance. I got my levels down decently to almost normal and my next goal will be trying to figure out how to regain insulin sensitivity - that is the big question for me, because there really is no "cure" and the resistance for those of us predisposed to it genetically may be with us for life. If insulin sensitivity can be regained, I might be able to balance my diet back to not be so carb-empty (not meaning bread/pasta but I would really like to be able to eat some missed fruits at least).

 

[Dark Horse]

my next goal will be trying to figure out how to regain insulin sensitivity

This article discusses ways to improve insulin sensitivity:- https://www.diabetesselfmanagement....nt-approaches/increasing-insulin-sensitivity/

 

[Brunneria]

@JayAmerican

Dark Horse got there first!
That is a good article, and it basically boils down to exercise, intermittent fasting, food choices, and medication such as Metformin (if you can tolerate it) which lowers insulin resistance a bit.

My body has IR that will not, as I understand it, ever go away from weight loss (subcutaneous or liver), so I see it as a lifelong battle to keep IR low on a daily basis. So that is very low carbing for life. And trying to stay active for life.