Endocrinologist Said...type 2 Can Be Cured

So by implication, I would assume you've lost weight?

If he actually used those words, then I further assume he meant that if you go back to the lifestyle you had before the reversal then you are likely to become diabetic again.

Did he say cured or did he say controlled?
Very big difference between the two.
If you are well controlled (and with an HbA1c of 39 you are pretty well controlled) then you shouldn't get any of the "nasties" that Type 2 brings but if you indeed gain weight especially by eating carbs then higher bloods will return.

Petaluk said:

Didn’t say cured,said it would go away and not return if I didn’t get fat again.

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So your thread title is a bit misleading?
Yes he's probably right... keep low carb and don't regain weight and you should be ok.

Well that really doesn't make sense, since plenty of non-fat people have type 2 diabetes. That sounds like a very unscientific thing to say which strikes me as being typical of the real thoughts and feelings of many HCPs - it's all down to being fat! Of course, there's also a lot of fat people who don't get diabetes too.

Break your arm? Lose some weight! Have a cold? Lose some weight! Can't have a baby? Lose some weight! Having a nervous breakdown? Lose some weight! There, that's pretty much all the major areas covered and one, easy, dismissive answer.

Could a skinny T2 diabetic consume the 6 serves of bread/grains/legumes each day, as indicated on the eatwell thing, along with the fruit, and not see wild fluctuations in their BGLs? The advice I was given was to eat a healthy diet, and I was shown a picture of a plate which was about 1/4 bread/cereal/oats etc, and at least 2 pieces of fruit per day - and there's always a banana! That woe caused me woe. There was also a can of coke, lollies, chocolate, etc in the bottom corner under the heading "eat occasionally".

Well - at the moment I could eat more carbs and still have normal BG levels - but I'd start to gain weight as soon as I did so - so it is fairly academic...

So does your body's response to carbs change? It's still early days for me (about 3 months of good BGLs) but if I eat more than 20g of carbs, I get a sustained high reading afterwards. I thought that was going to be the case forever now.

MrsGruffy said:

I was shown a picture of a plate which was about 1/4 bread/cereal/oats etc, and at least 2 pieces of fruit per day - and there's always a banana! That woe caused me woe. There was also a can of coke, lollies, chocolate, etc in the bottom corner under the heading "eat occasionally".

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That is actually a plate showing all the sponsors...minus their logos....

Petaluk said:

Didn’t say cured,said it would go away and not return if I didn’t get fat again.

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He’s more or less right, if you don't factor in other things that might go wrong as you age. Diet and exercise are critical. Plenty of books on it.

MrsGruffy said:

So does your body's response to carbs change? It's still early days for me (about 3 months of good BGLs) but if I eat more than 20g of carbs, I get a sustained high reading afterwards. I thought that was going to be the case forever now.

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To me that means you’re still diabetic. But then if you have room to lose more weught, get more exercise, he might get be right.

In the UK it's called "remission" and is formally declared (like a peace treaty in a war!) when you've had 2 HbA1c readings of less than 42 in a row. This is because, at this level you are considered to have very good control and be out of the danger zone for all the T2D nasties: as long as you stay at that level of control you will, indeed, be okay.

But that's often a flash point for T2's: "Well, I'm cured! I can do anything I like!" they think - and they return to the Eatwell Plate and take up going to the gym twice a week (with those lovely sports drinks), and have the occasional slice of cake at birthdays and Christmas and, because they're "in remission", no-one's really looking at their control anymore... so they slip.

It's not anyone's fault. It's that until really very recently, Type 2 Diabetes was seen as a progressive, life-changing disease that had no cure and no real management strategy. The notion of remission - of the T2 Diabetic taking active control and self-managing their disease is a very recent one: we're still advised there's no need to test our BG regularly, we're still given the Eatwell Plate as an example of a healthy diet, we're still not counselled about what to actually do when we hit the magical "Remission" day.

Which is why forums like this are so important: lots of people here are in remission and have maintained their control. This forum isn't just about managing diabetes, but keeping it under control for the rest of our lives.

Congratulations to you for accomplishing the first stage of your journey!

Final thought: The "get fat again" is because people who have T2D are insulin resistant. And a sign of insulin resistance is a spare tyre many of us (not all) carry around our middles. If you have had a diagnosis of T2D and get that tyre back, it's a clear danger sign. That's all he meant.

Roseanne01 said:

To me that means you’re still diabetic. But then if you have room to lose more weught, get more exercise, he might get be right.

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And to the question posed upthread, how does losing weight apply to TOFIs? For may of those with T2 weight gain is a symptom so how does treating a symptom rather than its cause constitute good practice?

I am still very suspicious of this whole 'Diabetes Gone' phrase that seems to be bandied about a lot just lately.
Even if one should recover a measure if insulin sensitivity it would never be to the level of a non Diabetic (T2).

It reminds me of that old, stupid joke. You know, the guy goes to the doctor and he's bent and twisted his arm behind his back, and he says, "Doc... when I do this, it hurts!" and the Doc replies, "Stop doing that, then", and then guy is all "I'm cured!"

If we treat our bodies badly, they break. If we stop, they recover. If we then start treating them badly (just like if we twist our arms behind our backs again), they'll just break again.

Does "cured" need to be a word we use? I feel far more empowered by the notion that I got it under control and am keeping it there. I don't need a cure: I did it for myself.

The insulin resistance thing is key.

We can lose weight and get slim, or be slim already, but if our insulin resistance stays high then our T2 is still lurking in a threatening manner, and carbs are doing us harm because the insulin resistance means we are producing more insulin that 'normal' to control our blood glucose to 'normal levels'.

This means that the HbA1c is just a vague and somewhat misleading indication.
A truer test would be to test our fasting insulin (not provided on the NHS) or do an oral glucose tolerance test combined with insulin clamping (as carried out by Kraft in 1000s of tests to assess people, allowing him to correlate high insulin with heart disease, metabolic syndrome and chance of future T2) This test is also not available on the NHS, to my knowledge.

I have to confess that if an endocrinologist said to me that my T2 blood glucose levels could 'go away' I would say 'yes, of course. already done it with low carb. But what about my carb intolerance and insulin resistance? Those haven't gone away, so I am still at increased risk and it takes effort and self discipline every single bloomin' day to just tread water without starting to sink. The root cause is still very much with me.'

Edtited for typos.

Not to mention the fact that we likely have significant beta cells loss upon diagnosis...since these are very slow growing cells, it may take a very long time to significantly restore them if ever...so use our remaining beta cells capacity judicially.

http://www.diabetesincontrol.com/in...hogenesis-of-type-2-diabetes-mellitus-part-3/