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Getting officially un-diagnosed

B

bnorcutt

Member
Messages
6
Type of diabetes
Type 2
Would this ever be possible with the support of a specialist, if someone can demonstrate that through tests that Type 2 is no longer present perhaps through weight loss enabling the pancreas to work more effectively or is it forever the case that you will be diagnosed as diabetic?

Ben
 
Conventional wisdom says once a T2 always a T2. That said there are ways to control your blood sugars, and for some this may enable your HBA1c readings to be below the diabetic threshold.
 
bnorcutt said:
Would this ever be possible with the support of a specialist, if someone can demonstrate that through tests that Type 2 is no longer present perhaps through weight loss enabling the pancreas to work more effectively or is it forever the case that you will be diagnosed as diabetic?

Ben
Click to expand...

I've read of people being "taken off the register" so it seems to be possible.

My own thought on that, as as someone who would love the miracle of restored insulin response through weight loss, is to think tactically.

I'd always think like a diabetic and be checking my blood sugars probably once a week to make sure they were doing what I expected.

And specific to your question, I'd want to keep getting the regular checks on eyes, feet etc to see if damage was progressing, so for that reason, personally, I would want to be registered as diabetic. Not that that was your question, just my own thoughts after asking the same question myself.
 
It depends on your GP. Mine says no although he did say I had excellent control. Others on this site have either been given the term remission or in a few cases resolved.
 
There are 2 codes the doctors can use if you fulfill certain criteria and, without medication, have normal HbA1c levels continuously over a period of time. One is "In remission" and this is used for long term good control with normal levels. The other is "resolved" which should only be used if the initial diagnosis was either incorrect, or BG levels were high due solely to medication such as steroids that are no longer taken and levels have returned to normal.

There doesn't seem to be a definition of "in remission" in the guidelines, so GPs have their own definitions, and each will be different. Personally, I prefer to be classed as a well controlled T2.
 
My latest result is 4.8 A year ago it was 4.5. My doctor said it had '' gone away '' Obviously I will have to continue on a low carb eating plan. I wasn't on meds, diet only. It is too easy to get caught up with different jargon. A cure hasn't happened yet though I saw an advert on the internet that a certain liquid could '' cure '' diabetes in 5 days!
 
@bnorcutt - This is an emotive subject.

I am one of those people who have been removed from the diabetes register, but I will never be un-diagnosed, because at the point of diagnosis, I had all the required diagnostic markers.

In my view, the only time an individual would be undiagnosed would be if it were proven an error had occurred in the diagnostic process, leading to a false positive decision. I imagine those circumstances would be exceptionally rare indeed.

Keep working on your numbers and once you have a track record with non-diabetic ranges for all the relevant markers, see how your medical team feel about it all.

Good luck!
 
start eating high carb high sugar foods and see how cured you are. your body is holding it at bay with the low carb diet you are not cured. please try to accept this you need to contol your bg for life.
 
Difficult one
My last HBa1c was 33.
I was never built to be 19 stone,now 12.
Apparently I have been described as a fixed producer of insulin,I can't increase my insulin to handle my weight.
BUT what is pre diabetic,surely that means you are and if you lower your readings you are are off the hook,erm don't get that.
 
paulus1 said:
start eating high carb high sugar foods and see how cured you are. your body is holding it at bay with the low carb diet you are not cured. please try to accept this you need to contol your bg for life.
Click to expand...

What tests have you done on bnorcutt to confirm this?
 
blanc71 said:
Difficult one
My last HBa1c was 33.
I was never built to be 19 stone,now 12.
Apparently I have been described as a fixed producer of insulin,I can't increase my insulin to handle my weight.
BUT what is pre diabetic,surely that means you are and if you lower your readings you are are off the hook,erm don't get that.
Click to expand...

I'd agree that someone who has been diagnosed as diabetic, then through some process (e.g. weight loss) becomes no longer detectable as diabetic via any medical investigation, is not "off the hook" when it comes to needing to be careful about what they eat in order to not be diagnosed as diabetic again.

But here's an interesting question: Is someone born yesterday any more "off the hook" about needing to be careful about what they eat in order to avoid becoming diabetic?

I certainly wouldn't presume, if someone manages to restore their insulin response, that that means their pancreas is as good as new. But in practical terms, I'd say if someone can behave like a non-diabetic, getting the same results as a non-diabetic, and all medical examinations including OGTTs suggest that they are non-diabetic, then we might as well call them non-diabetic, otherwise the word diabetes loses meaning.
 
blanc71 said:
Difficult one
My last HBa1c was 33.
I was never built to be 19 stone,now 12.
Apparently I have been described as a fixed producer of insulin,I can't increase my insulin to handle my weight.
BUT what is pre diabetic, surely that means you are and if you lower your readings you are are off the hook,erm don't get that.
Click to expand...
Off the hook is kind of what was implied when I asked for my latest results, or as @AdamJames says, off the register. I was told that no further action was required. hbA1c was 44, so you could say Type 2 is no longer present, but the reading is pre-diabetic, not non-diabetic, so further action IS required. I will ask for three-month bloods - I am of the 'in remission' school or, perhaps better, stasis: a predisposition to Type 2 is not likely to go away, so vigilance is still required.
 
AdamJames said:
I'd agree that someone who has been diagnosed as diabetic, then through some process (e.g. weight loss) becomes no longer detectable as diabetic via any medical investigation, is not "off the hook" when it comes to needing to be careful about what they eat in order to not be diagnosed as diabetic again.
Click to expand...
Agreed. If you get your sugars back to normal ranges, were to be considered no longer at any increased risk than the average Joe, then how does one explain the 50% risk women who have had gestational diabetes have of developing T2 within 20 years of the pregnancy?

Off the register is effectively a policy decision: you will no longer be offered routine screenings. In times of NHS austerity, this may seem like an effective approach to managing costs by your GP (especially if your GP is of the school of thought that believes that diabetes is a progressive disease).

The term remission infers that it is still there, but you are doing a stellar job of keeping it under control through dietary measures. If you manage remission for the rest of your life, then you could be considered cured. But this is a determination that could only be made retrospectively after one's death.

If you haven't already, check out the work of the late Dr. Joseph Kraft. Here is a link to Ivor Cummins' @FatEmperor 's blog on Dr. Kraft and his work:
http://www.thefatemperor.com/blog/2...ork-on-type-2-diabetes-insulin-reigns-disease
 
Bluetit1802 said:
There are 2 codes the doctors can use if you fulfill certain criteria and, without medication, have normal HbA1c levels continuously over a period of time. One is "In remission" and this is used for long term good control with normal levels. The other is "resolved" which should only be used if the initial diagnosis was either incorrect, or BG levels were high due solely to medication such as steroids that are no longer taken and levels have returned to normal.

There doesn't seem to be a definition of "in remission" in the guidelines, so GPs have their own definitions, and each will be different. Personally, I prefer to be classed as a well controlled T2.
Click to expand...
I would go along with what you have said totally. We got to be in this place for eating wrong foods and perhaps not being as active as we should be. If we went back to eating high Carbs etc after controlling our sugar levels,then surely we would end up being back in the same place as we started. Pre-diabetic or Type 2. When people used the word "Reversed" I prefer the word controlled.
 
Biggles2 said:
Off the register is effectively a policy decision: you will no longer be offered routine screenings. In times of NHS austerity, this may seem like an effective approach to managing costs by your GP (especially if your GP is of the school of thought that believes that diabetes is a progressive disease).
Click to expand...

This isn't actually true.

Someone taken off the register and coded as "in remission" (as opposed to "resolved") will remain on the list for all the screening stuff - retinal eye screening, foot checks, annual blood tests and an annual review with a DN or GP. This is a NICE directive.

Someone noted as "resolved" is likely to miss these screenings unless the GP has entered the "in remission" code on the system.

I will try to find the NICE directive on this.

EDIT
Only managed to find this at the moment http://www.berkshirewestdiabetes.org.uk/professionals/coding/diabetes-201cin-remission201d-coding
 
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Bluetit1802 said:
Someone taken off the register and coded as "in remission" (as opposed to "resolved") will remain on the list for all the screening stuff - retinal eye screening, foot checks, annual blood tests and an annual review with a DN or GP. This is a NICE directive.
Click to expand...
Oops, my bad, thanks for the correction @Bluetit1802! I should have used the word 'may' instead of 'will' be removed from the register.
@Dark Horse posted this useful information on an earlier thread:
http://www.diabetes.co.uk/forum/threads/reversal-or-remission-your-thoughts.102185/page-3
 
Biggles2 said:
Agreed. If you get your sugars back to normal ranges, were to be considered no longer at any increased risk than the average Joe, then how does one explain the 50% risk women who have had gestational diabetes have of developing T2 within 20 years of the pregnancy?

Off the register is effectively a policy decision: you will no longer be offered routine screenings. In times of NHS austerity, this may seem like an effective approach to managing costs by your GP (especially if your GP is of the school of thought that believes that diabetes is a progressive disease).

The term remission infers that it is still there, but you are doing a stellar job of keeping it under control through dietary measures. If you manage remission for the rest of your life, then you could be considered cured. But this is a determination that could only be made retrospectively after one's death.

If you haven't already, check out the work of the late Dr. Joseph Kraft. Here is a link to Ivor Cummins' @FatEmperor 's blog on Dr. Kraft and his work:
http://www.thefatemperor.com/blog/2...ork-on-type-2-diabetes-insulin-reigns-disease
Click to expand...

I'll check out that link, thank you!

Re "getting sugars back to normal ranges", the distinction I see important there is whether you do that by not eating carbs (because your metabolism can't handle them safely), or eating carbs (because your metabolism is ticking along nicely, either normal or practically normal).

I think correlating risk of T2 with having had gestational diabetes is a useful tool, and I guess it could suggest either a genetic predisposition, or that lasting damage was done during the gestational diabetes. Most importantly it helps any woman who has had gestational diabetes to be informed, and perhaps try to minimise other factors which increase her risk. But still, for any woman who has had gestational diabetes, it's not appropriate to diagnose her as Type 2 until her medical results say that she is.
 
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I have the dilemma of always having been unable to cope with carbs. I started eating low carb back when I was in my early 20s - I am eating almost the exact diet now as them - the only difference is that there are Lidl protein rolls which I know I can tolerate.
My weight was always the problem - I was rather muscular and buxom in my youth, so I weighed heavy when Twiggy was the ideal - so I might have been picked up as diabetic if I had ever had a blood test - urine test were always negative.
I was feeling ill on the high carb cholesterol diet I'd been prescribed - but if I'd been allowed to ignore the 'eat your carbs' advice I might never have been diagnosed at all.
As I have not seen my doctor since diagnosis, I am not certain that I am on the register - I had one test before diagnosis, not the two which is supposedly required.
 
AdamJames said:
But still, for any woman who has had gestational diabetes, it's not appropriate to diagnose her as Type 2 until her medical results say that she is.
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Agreed, NICE recommends increased screening in this population because of the increased lifetime risk of developing T2DM:
https://www.nice.org.uk/guidance/ng3/ifp/chapter/follow-up-care-and-future-pregnancy
I am someone who did progress to a diagnosis of T2DM after GDM. I remember reading somewhere that pregnancy could be considered a sort of 'metabolic stress test' for the future development of diabetes. Many of us revert to normal, non-diabetic BG levels after the birth of the baby as the immediate metabolic stress has been removed, but go on to develop T2DM later in life. Interestingly, our daughters are also at increased risk for developing PCOS if we had GDM while they were in utero. This all suggests a strong genetic component. There are so many unknowns with this condition.
 
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