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how long until remission

C

cdriesse

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Diet only
Hello everybody,

I am newly diagnosed with type 2 diabetes as regular health check showed level of 104 HBA1c 3 weeks ago. Having had gestational diabetes that I was able to control with diet, I am wondering how long it takes before type 2 goes into remission. I managed to bring the glucose level which was 20 2 hours after a breakfast containing cereal with milk, down to 8 90 minutes after meal within 2 day time span by changing diet (no more grains or chocolate).
Somehow I am scared to go on medication, although I know the high glucose levels are not good for my body, especially liver and kidneys. Hence I would like to see if I can go into remission by controlling my diet and increasing my exercise levels. Has anybody ever tried this? How long did it take? First drop from 20 to 8 in glucose levels was quick, but how long does it take to get to levels of 6?

For those on remission for a long period of time, do you always need to follow the diet or can you occasionally deviate? It is hard to follow the diet when food is provided at work meetings.
 
Hi @cdriesse and welcome to the forum.
While I am in remission (for about 3 yrs) I did o from a much lower HbA1C level than you are at.
However from what I have seen in the forums, if somebody takes it seriously (not just cutting out grains for example, but actually going low carb or Keto) then pre-diabetic BG levels without medication is possible for over 50% of people within a couple of weeks.
Note that remission means maintaining those pre-diabetic or non-diabetic levels for several HbA1C tests, which takes additional months.

Once in remission, the odd higher carb meal or even whole day doesn't throw us off much, but this is not like a conventional diet - it's a lifestyle thing and so needs to be sustainable! Though I know of 2 people (out of hundreds) who claim to be 'cured' - but I have serious doubts and think that their luck just has not yet run out.
 
Hello and welcome, @cdriesse .
It isn’t possible to be able to estimate how long it will take for you to bring your blood glucose levels under control. We are all individuals with our various differing circumstances. However, many of our members, vey quickly, gain control by drastic reduction of carbohydrates in their meals. They don’t regard it as a diet. More a way of life. Most of us find that we feel so much better following a low carb regime, that we would not choose to go back to consuming more carbohyrate foods and drinks.

There is some information after my signature that is for new members. Scroll down at the end of the post. Have a read, and come back with questions. Members will guide from their own experiences.
 
A word of caution, remission is the holy grail but some of us never get there, doesn’t mean that’s a fail, there are all sorts of reasons why not. It doesn’t mean you can’t have great control and be healthy.

I’ve never managed remission even though I’ve eaten VLC then keto for nearly 14 years, but what I did achieve was getting off all meds which at the beginning was insulin then max dose Gliclizide, statins, blood pressure tablets I lost a LOT of weight. I maintain a level just above pre diabetes.

Remission doesn’t mean you can go back to your old ways, it means you have to keep doing what you’ve been doing so changing your lifestyle is just that, a lifestyle not a “diet until….” Just aim for the best you can be, this is your journey no one else’s, if you do achieve remission then that’s amazing but if you don’t that’s not the end of the world you’ll still be a whole lot healthier
 
I was diagnosed almost exactly 10 years ago. I have been fortunate to have been able to achieve and maintain remission.

When remission happens os unknown, when it is recognised is patchy, even though there is now an accepted definition of remission for T2. That is, when your HbA1c — a measure of long-term blood glucose levels — remains below 48mmol/mol or 6.5% for at least three months, without diabetes medication.

On that basis, it'll likely be a minimum of around 6 months before the relevant measures can be taken, although as has been said, it isn't something everyone can manage, for many reasons.

Personally, I would urge you to concentrate on finding a new way of eating and drinking that supports improved blood glucose, and see where that takes you. It is more important that you find a way to improve your glucose you can stick with, because whilst remission is all very fine, there have been many folks who achieve remission then some time later, find themselves back at square one.

Please be clear, I'm not suggesting those folks necessarily went off track and started (or started again) eating and drinking stuff that wasn't doing them any favours. Things like illness, stress, changes in circumstances, medications for other health conditions are just examples of some of the things that can go awry.

This is a long game, so focus on improving things, then regroup an decide on your next steps later.
 
It's good that you are starting to identify potentially difficult areas such as work meetings. It seems almost compulsory to eat the food as it's there, it's free, and everyone else is getting stuck in. You could eat something that is fine for diabetics before you go in, then you won't feel hungry and shouldn't be tempted. At first people may try to cajole you into joining in because communal eating is a people thing, and also some others may be tucking into unsuitable food e.g. high calorie when they are trying to diet, and like everyone else to be doing the same. But rehearse your script and smile and refuse in whatever way you like.

Part of this marathon is keeping the goal in sight, and for all of us that goal is to be as healthy as we can within the parameters of our physical challenges (a lot of us have more than one illness). So identifying potential problem areas as you just have with the food at work meetings gives time to form a battle plan.
 
I agree with everything said above - and like you started off trying to set 'hard timelines' - i.e. by this number of weeks i will have achieved this or that.
Remission in the NHS is broadly defined as an HbA1C below 48mmol/mol on two separate tests at least 6 months apart - without medication. (https://diabetesmyway.nhs.uk/keeping-healthy/type-2-diabetes-remission/)

My first test (leading to diagnosis) was end of Jun 23. I have chosen not to medicate, but to lose weight and reduce BG by following a ULC / almost Keto approach. My next test was this morning and if this has gone well will mean at least 6 months before remission (another test in Mar/Apr 24) - so an absolute minimum of 9 months - FOR ME.

Whilst remission is my goal i have had to make it an outcome of the changes i have made, rather than the thing i am aiming for completely - what i mean is that the sustainable changes i have made to diet, exercise and weight loss will hopefully lead to remission. Not the other way round where remission (making the numbers) drives everything else - otherwise it leads to unsustainable behaviors and short termism.

Making it lifestyle first means i am no longer focused on the single measurements (BG, Kg, BP etc) but only measure BP and KG weekly and look at the trend (much better for MH) - as long as the numbers are going in the right direction i will hopefully get there eventually

Lots of great info on the site and some really lovely people who can advise of their personal journeys and experience
 
I'd add that even as your post meals levels drop (a rise of less than 2 between the pre meal and 2hrs post meal is good) you will probably find your first test of the day remains high. I found I had to drop my carbs a bit more and even then it took an extra couple of months for that 'dawn phenomenon' to stop.
 
Hi @cdriesse, welcome to the forum.

I was diagnosed in July with an hba1c of 83. At that point, my fingerprick BG readings were 15s before meals, 17-18 after meals.

As others have said, remission is an ambition of mine, but it's not my primary objective. My reasons for this are a) it may not be fully within my control as to whether I can achieve that, and b) I can't monitor it personally and track it, so it makes motivational goals difficult to set from week to week, month to month. Point b) is particularly important on this rollercoaster for me. You'll have good days, bad days, and everything in between - especially at the start. Realistic, short term goals help me through the tougher days and keep me going, and they're always based on something I can track myself, at whatever intervals I want.

My primary goal is to lose a lot of weight. It's an underlying cause of many of my health issues and helps with managing diabetes. I've had a number of sub-goals for weight loss, which I've achieved so far, and I'm working towards my next one. There will then be many more until I reach my overall weight goal. My secondary goal is to keep my BG readings before and 2hrs after meals below 6 mmol. Again, there have been several sub-goals to this since July. My hope is that I can achieve remission by hitting my two primary goals, but remission (should that happen) will be a consequence of overall healthier diet and lifestyle goals that improve multiple health conditions/risks, not just diabetes.
 
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I think you might be confusing your fingerprick readings with HbA1c results. Everyone's current blood glucose levels will fluctuate all the time in response to stimuli, particularly food, but also exercise, temperature, illness, stress etc.

In addition our livers have a habit of adding extra glucose when they think we might need it. Exercise therefore may well raise your BG levels in the short term - it raises mine, probably because the body needs more fuel and the liver obliges.

Your fingerprick readings will tell you a lot about how your system deals with particular foods, for example, but it will only give an indication about what the bigger picture looks like. That's not to minimise the impact you've already achieved by changing your diet, and eliminating a food that had an unacceptable result.

A lot of people on this forum have achieved remission through diet - I'm one of them. I was diagnosed in December 2019 /January 2020 and back at normal levels (36) by April 2020. No medication. My GP used a definition of remission that required a full 12 months of normal range results, so I wasn't officially in remission under that definition until April 2021.

I pretty much stick to the plan, largely because I don't want those symptoms back. There are very occasional breaches - maybe every four to six months? when I might have a gelato on holiday. I would definitely want to avoid allowing breaches in my everyday normal way of eating. But that's what suits me. You need to find what works for you.


There's now (since May 2022) an internationally agreed standard for what constitutes "remission" - it's actually much more lenient than some of the definitions around, including the one that was applied to me. Basically the agreed standard is now two HbA1c results under 48, the two measurements being at least 182 days (six months) apart, and with no glucose lowering medications from 90 days (three months) before measurements started. Link attached below:

https://diabetesjournals.org/care/a...ence-and-Characteristics-of-Remission-of-Type
 
Technically I have been in remission for 2 years. But I don’t regard it as remission, just under control. I know that if I went back to my previous lifestyle I would be out of “remission” in about 2 weeks.

I did what most here have done, lost weight, low carb (though my daily average is about 100gms) and exercise.

I have found most important component is resistance training. Building muscle is the best way to actually get your body to improve BS management.
 
But - if intensive exercise is past tense or unsuitable for you - fear not. Others of us have reduced our BG massively by diet alone. If you can manage any sort of exercise, even just walking, it's a plus, but not everybody can. That doesn't mean we can't reduce our bg.
 
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