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Definition of 'Reversed / Cured' Type 2

Energize

Well-Known Member
Messages
810
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi

I'm very interested in what is considered to be the criteria of 'Reversed' or 'In Remission' of Type 2. I'm sure several people will have their own interpretation of this, of course, but is there a 'standard criteria' that should be met?

My feeling is that the criterira would be something in the line of achieving HbA1c below 6% without any medication and with being able to eat a certain amount of carbs for a certain length of time.

I certainly congratulate members who have reached this level. I'd very much like to reach this aim myself, of course

What do other members feel to be the definition / criterira for claiming to have 'Reversed' or be 'in Remission'?

Thanks
 
Hi @Energize, I do not believe there are many serious claims that Type2 diabetes can be cured; gestational diabetes I think can be cured. Many commentators use remission or reversed. I like reversed because I interpret this as the opposite of progressive, which seems to be an accepted description of the consequence of uncontrolled diabetes, and reversed does not imply a permanence if control is not maintained. I could be wrong but I think 3 successive HbA1c's of 5.7 or below with a "normal" secondary insulin response which places blood sugars within the post meal (prandial) level is considered reversed - some I know expect a normal phase 1 insulin response during the first circa 10 minutes of a meal. Some believe you should be able to eat "normally" and not have diabetic levels of blood glucose. I do not subscribe to this as I would say most reversed diabetics are food educated and do not wish to eat like before, in addition to having taste being re-programmed.

Health care professionals tend to use the term resolved on patient notes, but there seems no accepted standard for a timeframe of good results; I like 3 as this is usually at least a year plus of HbA1c's within the non-diabetic range.
 
Many thanks, @Mbaker

Like you, I don't accept the term 'Cured' but can accept 'in Remission' or 'Reversed' and also accept this state is potentially temporary, being possible to revert if weight and diet should be neglected.

I like the x 3 HbA1c below 5.8% as a criteria, accepting this to be within 'normal' range. I hadn't given thought to 'phase 1 insulin response' and, to be honest, don't know anything about this, nor how it is measured etc.

I can understand what you mean by being 'food educated' and therefore possibly not eating entirely 'normally' but I would hope that someone 'reversed' would be carb tolerant to a reasonable degree - maybe I'm wrong

Thanks Mbaker

I'll be interested to read how others see this.
 
Just to be completely contrarian, I'd like to use a completely different term - "arrested"

I don't think I'm reversed or in remission because I know my first phase response isn't working properly. It's better than it was when I was diagnosed, but still not "normal", yet I've had "normal" A1cs for the past 4+ years.

It also helps me stay on track mentally by discouraging mental games of chicken and "what if".
 
I would say that you've reversed/cured it if you can pass the three tests that are used to diagnose it: fasting blood glucose, HbA1c and OGTT (i.e. a doctor looking at your results would say you are non-diabetic and not pre-diabtic). The only caveat is that prior to the OGTT you'd need to eat some carbs for a few days if you are on a low carb diet, since you may have "physiological insulin resistance" from the low carb diet. Adding carbs back in to your diet for a few days should make you insulin sensitive again if you are not diabetic.
 
NoCrbs4Me said:
The only caveat is that prior to the OGTT you'd need to eat some carbs for a few days
Click to expand...
That's the big stumbling block for me - even if I could be bothered to do a home DIY OGTT, or twisted my GP's arm into giving me one, I really have no interest in carbing up. The very idea makes me feel vaguely nauseous.

I have my good days and bad days with fasting levels as well - some days normal, sometimes in prediabetic range.
 

I think people get too hung up on reversal/cure. All you can do is the best you can do. You may or may not be able to reverse it. The goal is good blood glucose control whether you can do it by diet or if you need meds as well. Really, the OGTT should be used for diagnosis, not to identify reversal.
 
While many of us have managed to achieve normalized glucose level with HbA1c ~ 5.5%, few if any have been able to restore normal 1st phase insulin response sufficiently to handle high carb loads.

Dropping the carbs gives our pancreas and liver some relief. But much work is still needed to heal from the years of damages. That's why I find Valter Longo's research on stem cells regeneration thru fasting/refeeding cycles insightful and promising. Addressing some of the gaps/issues faced by long term low carbers or those on chronic calorie restricted diet.

Clearing away the damaged and regenerating healthy new cells is the holy grail...
 
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Yes, an OGTT with glucose AND insulin would be ideal - the test as devised by Kraft. Fat chance of getting a doctor to agree to do it though.
 
Im not sure why people worry about definitions like cured, remission and reversed, dont we have enough to worry about in life as it is, why look for something else.

Maybe ignorance is bliss but Im just happy that Im well controlled, thats enough for me.....Check my avatar
 
For me the definition of remission basically is being asymptomatic that is if you no longer exhibit the signs or symptoms of diabetes type2 then you are in remission.
 
JohnEGreen said:
For me the definition of remission basically is being asymptomatic that is if you no longer exhibit the signs or symptoms of diabetes type2 then you are in remission.
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I didn't have any symptoms when I was diagnosed.
 

A couple of links :-
reverse
rɪˈvəːs/
verb
past tense: reversed; past participle: reversed
  1. 1.
    move backwards.
    "the lorry reversed into the back of a bus"
    synonyms: back, go back/backwards, drive back/backwards, move back/backwards, send back/backwards;
    back-pedal
    "the car reversed into a lamp post"



  2. 2.
    make (something) the opposite of what it was.
    "the damage done to the ozone layer may be reversed"

cure verb [ T ] (MAKE WELL)
illness healthy again:

At one time doctors couldn't cure TB/cure people of TB.
solve a problem:

More examples

  • He made wild claims about being able to cure cancer.
  • Drugs have been developed to cure some duodenal ulcers.
  • Some people try hypnotism to cure themselves of addictions.
  • She tried to cure the pain in my knee by putting manual pressure on the joint.
  • The medicine won't cure her - it merely stops the pain.
Thesaurus: synonyms and related words
 
 
@Energize - I have been removed from the Diabetes Register, and my records now show "Diabetes Resolved".

This came about when I was having a "robust" discussion with my GP about lipids and statins. During that she said, "all diabetics should be offered statins". My response was , "When do I get any credit for serial HbA1cs well below diagnostic thresholds", thinking she might soften her stance somewhat.

What she did then was suggest taking me off the register; once she had worked out how to do it. I did ask her criteria and she suggested it was my serial HbA1cs (they're in my signature), and how far adrift they are from the threshold, these days.

I wasn't too fussed about it, but agreed, just to stop the fast-forward thinking that so many medics seem to have that everything from dandruff to major issues are due to diabetes. Personally, I want a medic with a more open mind than that.

Moving forward, when asked if I am diabetic, by a medic, I always say I was diagnosed, but am no longer on the register. Recently, when I had a first consultation with an Endocrinologist about something else, my historic diagnosis came up, in another context, and he was curious how things had been for me, but passed no further comment on it.
 
There are some who hope to be cured so that they can go back to their old eating habits. Even if the diabetes doesn't return they will put back on any weight they have lost? If there is a cure it would have been world headlines, which it hasn't been. Personally speaking my doctor has told me that I don't have diabetes anymore because my sugar level is now 4.5 but I am still thinking I have and will continue with the way I have been eating for the last three years.
 
Well, I just tested after having a homemade chocolate cookie, and a banana muffin with a cup of coffee.
4.8
I consider that reversed, and I haven't put the weight back on.
 
But do you consider yourself cured and do you believe that your diabetes will EVER return?
 
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