How do you know?....

[LindsayJane]

So, I've been reading posts on here for a week and have noticed that a few of you have 'in remission' or 'diabetes reversed' on your status. How do you know? This is what I'm aiming for. My BG is down from 10 to average 4.6 fasting and I'm following a very strict low card diet (which is sometimes difficult as I work in a pub/restaurant and there are temptations all around). I would love to know how long it took those who have been successful and how it was confirmed. Peace and love to you all x

 

[bulkbiker]

It is usually defined as a series of HbA1c test results which show blood sugars in the "normal" range.
This seems to vary a bit. My HbA1c levels have been sub 30 mmol/m since July 2016 but it wasn't until my last review that the Diabetes Nurse decided that I could be classified as officially "In Remission" although she did say it should have been done "a while ago".
If you are Prof Roy Taylor of the Newcastle Diet then they say its HbA1c below 48 mmol/m for 12 months (Virta Health use the same criteria). Personally I think that's rubbish as anything over 42mmol/m means you are pre-diabetic.

 

[JoKalsbeek]

So, I've been reading posts on here for a week and have noticed that a few of you have 'in remission' or 'diabetes reversed' on your status. How do you know? This is what I'm aiming for. My BG is down from 10 to average 4.6 fasting and I'm following a very strict low card diet (which is sometimes difficult as I work in a pub/restaurant and there are temptations all around). I would love to know how long it took those who have been successful and how it was confirmed. Peace and love to you all x

You know when your HbA1c has been in the non-diabetic range (under 42) for a prolongued period of time. I didn't state it with any confidence until I was 2 years in myself. My doc still has me classed as a T2 for the regular tests etc, which is how I want it.

 

[LindsayJane]

You know when your HbA1c has been in the non-diabetic range (under 42) for a prolongued period of time. I didn't state it with any confidence until I was 2 years in myself. My doc still has me classed as a T2 for the regular tests etc, which is how I want it.

I suppose that's best to make sure you're still in the loop and being monitored reguarly. Thank you for the info - I have a number to aim for now which will be a great help xx

 

[LindsayJane]

It is usually defined as a series of HbA1c test results which show blood sugars in the "normal" range.
This seems to vary a bit. My HbA1c levels have been sub 30 mmol/m since July 2016 but it wasn't until my last review that the Diabetes Nurse decided that I could be classified as officially "In Remission" although she did say it should have been done "a while ago".
If you are Prof Roy Taylor of the Newcastle Diet then they say its HbA1c below 48 mmol/m for 12 months (Virta Health use the same criteria). Personally I think that's rubbish as anything over 42mmol/m means you are pre-diabetic.

Then my aim will be for sub 42 - see what happens. Thank you for your reply - I love this site! So much knowledge to share xx

 

[Rachox]

I posted a similar question here about a year ago:
https://www.diabetes.co.uk/forum/threads/should-i-classify-myself-as-‘in-remission’.136346/page-2
The thread ran to 7 pages but by post #27 I had made my decision. My HbA1cs have been non diabetic for about 18 months now so I feel vindicated for changing my avatar to “in remission”. In my heart of hearts I consider myself ‘very well controlled’ but that’s not an option here.
This is always with the proviso that remission means “a temporary diminution of the severity of disease or pain”

 

[Deleted Account]

Curious (nosey) person with type 1 here.
I am wondering what is the practical side of being declared/registered/certified/... "in remission" by your GP.
I understand the amazing and justified feeling of achievement but I would be concerned you may lose any ongoing support, blood tests, etc. from your doc.

 

[Rachox]

Curious (nosey) person with type 1 here.
I am wondering what is the practical side of being declared/registered/certified/... "in remission" by your GP.
I understand the amazing and justified feeling of achievement but I would be concerned you may lose any ongoing support, blood tests, etc. from your doc.

I entirely agree. I’m quite happy to be kept firmly as a Type 2 at the Drs to be sure to get all the check ups I’m entitled to (and free prescriptions! )

 

[bulkbiker]

Curious (nosey) person with type 1 here.
I am wondering what is the practical side of being declared/registered/certified/... "in remission" by your GP.
I understand the amazing and justified feeling of achievement but I would be concerned you may lose any ongoing support, blood tests, etc. from your doc.

You still get all the tests (or should do).. It is also useful when a nosy patient like me asks how many of the 1107 T2's in the practise are classed as "In remission" and gets the answer 27 which then leads you to say "could do better"?

 

[Member496333]

My GP Surgery are worse than useless with diabetes, but it doesn’t matter to me as I’m well enough informed to manage my own health in that regard without their input or “assistance”. I’m still registered diabetic but that’s fine with me as it means I get a free eye exam once per year

My own definition of reversed is no medication and no symptoms. Including no hyperinsulinemia. Therefore no possible clinical diabetes diagnosis or even insulin resistance. I have no idea if my doctor agrees and I don’t care...they seem to have forgotten all about me anyway

 

[Spl@]

I entirely agree. I’m quite happy to be kept firmly as a Type 2 at the Drs to be sure to get all the check ups I’m entitled to (and free prescriptions! )

On the other side. I am very happy I dodged the t2 bullet.
As a class 1 Hgv driver avoiding the official t2 tag is a biggy. Nothing to declare no nasty dvla surprises. Just an average Joe as far as the dvla is concerned and long may it stay that way.
Same with work. Not being diabetic saves the associated hoops I would have to jump through.
My job would be fine. Extra medicals and such though. The firm I work for is hhhhhhuuuuuugggggeeeee and as such do it totally by the book HR wise.

 

[JoKalsbeek]

Curious (nosey) person with type 1 here.
I am wondering what is the practical side of being declared/registered/certified/... "in remission" by your GP.
I understand the amazing and justified feeling of achievement but I would be concerned you may lose any ongoing support, blood tests, etc. from your doc.

I only want to be labeled "in remisson" here... Not with my GP. And if she would suggest it, I'd fight it tooth & nail. (Not that she's going to, she's too interested in my testresults, being the only keto-dieter in the practice.)

 

[LindsayJane]

I posted a similar question here about a year ago:
https://www.diabetes.co.uk/forum/threads/should-i-classify-myself-as-‘in-remission’.136346/page-2
The thread ran to 7 pages but by post #27 I had made my decision. My HbA1cs have been non diabetic for about 18 months now so I feel vindicated for changing my avatar to “in remission”. In my heart of hearts I consider myself ‘very well controlled’ but that’s not an option here.
This is always with the proviso that remission means “a temporary diminution of the severity of disease or pain”

Hello - I down loaded the mySugr app yesterday following your recommendation on another thread. Thank you for it - took me a while but I've put all my recent info on it and am now looking forward to the first 'result'. I'll take a look at the link above when I have a moment spare -busy day today! Thank you again. Peace and love xx

 

[rmz80]

There seems to be a significant number of members to this site with an HbA1c below 42.

I would be interested in one aspect of “now in remission” status is the amount of damage that a previous high HbA1c has caused. Could this be a similar situation cigarette smokers get years after a person gives up. I’ve not read anything on this subject

 

[DCUKMod]

My status, since November 2014 is "Diabetes Resolved".

Nothing about my medical care has changed. I don't get weighed, but never was before I have never, ever been measured. I had my feet tickled once, a few months after diagnosis, but I do keep an eye on things down there.

I still have retinopathy screening, and I have an annual A1c. In fact, if I have a reason, the GP will run my bloods on request.

In my world, I see much of how an individual is cared for, moving forwards, is with the individual. If they want to keep on top of things, then usually the Doc seems willing enough to help keep an eye. If the individual is passive, they'll get what they're given, when someone thinks of them, but then that's often as it is with an active T2 status in play.

 

[bulkbiker]

My status, since November 2014 is "Diabetes Resolved".

Nothing about my medical care has changed. I don't get weighed, but never was before I have never, ever been measured. I had my feet tickled once, a few months after diagnosis, but I do keep an eye on things down there.

I still have retinopathy screening, and I have an annual A1c. In fact, if I have a reason, the GP will run my bloods on request.

In my world, I see much of how an individual is cared for, moving forwards, is with the individual. If they want to keep on top of things, then usually the Doc seems willing enough to help keep an eye. If the individual is passive, they'll get what they're given, when someone thinks of them, but then that's often as it is with an active T2 status in play.

Isn;t that dodgy though? I thought that in these enlightened times that its "Diabetes in Remission" or nothing. The Diabetes Resolved classification was meant to have been retired a while ago. The chief partner of our surgery didn't know this but the area Diabetes Nurse said that was indeed the case. Of the 27 Remission cases that they said they had 11 were classed as "resolved" and I think these will be amended to in Remission soon.

 

[Resurgam]

There seems to be a significant number of members to this site with an HbA1c below 42.
I would be interested in one aspect of “now in remission” status is the amount of damage that a previous high HbA1c has caused. Could this be a similar situation cigarette smokers get years after a person gives up. I’ve not read anything on this subject

Hba1c is glycated haemoglobin - of itself it does no damage.
The situation which meant that glucose attached to haemoglobin could be due to a constant slightly elevated glucose level, or to a few high spikes each week - it is impossible to tell, and so no conclusion can be drawn with any safety. It can be equated to an average blood glucose, but the average of 100 and 0 and 49 and 51 is 50.
I changed my status to in remission after Hba1cs of 47, 41 and 42 as the HCPs at the GP practice have no interest at all in my progress, and I have not seen my GP since diagnosis in 2016.

 

[britishpub]

I too am coded as Diabetes Resolved

In fact on the patient services website that my surgery uses it shows Type 2 diabetes mellitus as a previous diagnosis.

Personally I don't consider myself anything other than someone with T2D, but that is just the way I prefer to look at things.

As posters have said previously, my care hasn't changed (it's still minimal) but I do get an annual eye screening, a text inviting me for a flu jab every year and an annual HbA1c test (and if I'm really lucky I might be able to book an appointment to see a GP in less than 5 weeks )

 

[DCUKMod]

Isn;t that dodgy though? I thought that in these enlightened times that its "Diabetes in Remission" or nothing. The Diabetes Resolved classification was meant to have been retired a while ago. The chief partner of our surgery didn't know this but the area Diabetes Nurse said that was indeed the case. Of the 27 Remission cases that they said they had 11 were classed as "resolved" and I think these will be amended to in Remission soon.

You know me and labels. If you can tell me what will change I'll think it through, but as of now, nothing changed when my status did, so I see no material need for action.

Will it affect me and my care for me to make a fuss and have it changed? Will it change how I care for myself?

 

[Bluetit1802]

Curious (nosey) person with type 1 here.
I am wondering what is the practical side of being declared/registered/certified/... "in remission" by your GP.
I understand the amazing and justified feeling of achievement but I would be concerned you may lose any ongoing support, blood tests, etc. from your doc.

A GP coded me as Diabetes Resolved backdated to June 2014. This was done without any discussions with me, and is against my wishes. I still have 6 monthly blood checks and one nurse review a year, plus my annual retinopathy screening. No more foot checks though. However, the downside for me is when I buy meters, strips, the Libre etc. I am no longer entitled to the VAT exemption, and that makes it expensive. Despite all that, my GP still enters "Type 2 diabetes" when she does my annual Q-Risk score, virtually doubling my CVD risk. She wants it both ways.

So, I've been reading posts on here for a week and have noticed that a few of you have 'in remission' or 'diabetes reversed' on your status. How do you know? This is what I'm aiming for. My BG is down from 10 to average 4.6 fasting and I'm following a very strict low card diet (which is sometimes difficult as I work in a pub/restaurant and there are temptations all around). I would love to know how long it took those who have been successful and how it was confirmed. Peace and love to you all x

Doctors vary in their opinions and protocols. Some follow the Professor Taylor definition of HbA1cs under 48, others look for the HbA1c to be under 42. Some don't agree with either of these and won't code patients as in remission at all.

This is the international standard for remission:

Following international standards [1,2] a person goes into diabetes remission when the following conditions are fulfilled:

1. Had a diagnosis of diabetes
2. Fasting Serum Glucose (FSG) is less than 100 mg/ml (5.6mmol/l)
3. HbA1c is less than 6.0% (42mmol/dL)
4. There is no active hypoglycemic therapy (either pharmacological or surgical)

We define three levels of remission:

• Initial. When the conditions are fulfilled for three months
• Complete. When the conditions are fulfilled for one year
• Operational cure. When the conditions are fulfilled for five years or more

References:
1. Buse JB, Caprio S, Cefalu WT, Ceriello A, Del Prato S, Inzucchi SE, et al. How do we define cure of diabetes? Diabetes Care. 2009 Nov;32(11):2133–5.
2. World Health Organization (WHO). Global Report on Diabetes 2016 [Internet]. Geneva: World Health Organization; 2016. Available from: http://www.who.int/diabetes/global-report/en/

https://www.diabetesremission.org/our-task/

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