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In remission

Hi @maine1965 In my opinion, remission isn't a cure, just another milestone in the marathon called controlling your diabetes.
Like everything else, people have different definitions of remission, just as the USA has a lower starting point for Pre-Diabetes than the one we use in the UK.

As far as I know, there is no cut off pint below which we are certain to avoid getting a diabetes adverse health event, it's more of a sliding scale with the likelihood dropping in line with the BG levels.

Enjoy your life! If you are happy with your eating, exercise, health, then fine. If you want still want better, then also fine. But don't ruin it by getting obsessive and making things unsustainable.
 
Well done getting into remission:) I would say just keep on doing what your doing and try not to get complacent, keeping to the lifestyle that got you there will help keep you there
 
maine1965 said:
Looking for advice on how to proceed forward from remission...How to maintain it long term?
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Hi maine1965

It's a really good question - it's one of those things that was important to work towards: I spent months focussing on remission (my practice used the definition of one full year with no reading above 42 while on no medication) and once achieved (April 2020) it sort of felt a bit flat at first.

I'm in my fourth year of low carb, third year of remission and to me that means a substantial length of time without symptoms while nothing's got worse. I've lost a bit of weight and since last year I'm playing football again. My insulin sensitivity seems to have improved a little and I'm sticking to my ~20g a day. I still feel better than I have for some time. I think I have learnt to enjoy being in remission for its own sake.
 
I hope to stick to low carb for the rest of my life, because not only is my annual HbA1c nice and low but also my cholesterol and other tests (liver, kidneys, etc) are looking good.

I decided to up my carbs a little after a year in remission. And this is fine so far but I'm not taking any crazy risks.
I experiment with new recipes, and new vegs I haven't tried before to keep it interesting.
 
ianf0ster said:
Hi @maine1965 In my opinion, remission isn't a cure, just another milestone in the marathon called controlling your diabetes.
Like everything else, people have different definitions of remission, just as the USA has a lower starting point for Pre-Diabetes than the one we use in the UK.

As far as I know, there is no cut off pint below which we are certain to avoid getting a diabetes adverse health event, it's more of a sliding scale with the likelihood dropping in line with the BG levels.

Enjoy your life! If you are happy with your eating, exercise, health, then fine. If you want still want better, then also fine. But don't ruin it by getting obsessive and making things unsustainable.
Click to expand...
 
Hiya Ian, I found out a few weeks ago once diabetic that remission is possible for up to 15 yrs… I actually thought I could totally get rid… honestly I am still really annoyed even though I know I shouldn’t be… I’m not even feeling like eating today… but I’m going to. It’s not the end of the world and I will keep going..
 
I was diagnosed with T2 in November 2013, and three months later I had reduced my HbA1c to a pre-diabetic level by eating a low carb/ketogenic style diet. Since then I've reached and maintained lower pre diabetic levels, lost about 30 kilos without actually trying, and finally came off my diabetic meds (metformin) in 2017. All done by testing and refining my diet slightly, which actually suits me very well and is closer to what I ate growing up than the high carbs I ended up eating for some years before my eventual diagnosis.

As there appear to be various different definitions of remission, I won't claim this, but my GP calls me well controlled, and I know it's certainly possible to keep to non-diabetic levels long-term, as for me it's been nearly 10 years now. (And I'm still somewhat overweight and now inactive and coming up to 81 years old - so if I can do it, hopefully so can you...)
 
maine1965 said:
Hiya Ian, I found out a few weeks ago once diabetic that remission is possible for up to 15 yrs… I actually thought I could totally get rid… honestly I am still really annoyed even though I know I shouldn’t be… I’m not even feeling like eating today… but I’m going to. It’s not the end of the world and I will keep going..
Click to expand...

October will be the 10th anniversary of my T2 diagnosis, and February the 10th of my being back into fully non-diabetic numbers, meds free, so I have maintained remission for a while now.

As time goes on, the way of eating becomes the new normal and it's just me now. Over time, my insulin sensitivity has improved and I can eat quite a bit of carb now, but still maintain remission. I found that last bit out after a log trip overseas, where tropical fruit is everywhere (including in my tummy), coupled with a hard time emotionally with the loss of a close friend. A surprise HbA1c still came back at 31. So far, so good.

I'm back to my more usual, comfortable UK ways of eating, so hopefully I'll be good to go for a good while longer.

I don't know where you got the 15 years from. I haven't seen much meaningful data on remission, except for lots of self-reported anecdotal stuff, like on here.

I do know of some medico-academic studies with interests in remission - either by including sub-cohorts of participants in remission, and I know a study kicking off in the autumn with quite a bit looking at remission, per se. The former study into heart health is still recruiting participants - both in remission or not, but the latter is still in the focus group stages.

There is interest out there, and the strange idea that remission is a good thing (Yes, that was sarcasm).

There's a lot to be hopeful for these days with T2. The outlook is way more optimistic than even when I was diagnosed almost 10 years ago.

Stick with it.
 
maine1965 said:
Hiya Ian, I found out a few weeks ago once diabetic that remission is possible for up to 15 yrs… I actually thought I could totally get rid… honestly I am still really annoyed even though I know I shouldn’t be… I’m not even feeling like eating today… but I’m going to. It’s not the end of the world and I will keep going..
Click to expand...
Interested to know where you read that. There is a scarcity of "official" accounts of remission. I've never seen any time limit, and can't think why there would be one.
 
When in doubt, have a look on the other website:

Diabetes remission

Diabetes remission in people with Type 2 diabetes means that your blood sugar levels are below the diabetes range without needing to take diabetes medication any more. Here we’ll explain what aiming for diabetes remission could mean for you.
www.diabetes.org.uk www.diabetes.org.uk

I personally take issue with quite a bit of what's claimed on there, particularly around the absence of low-carb as a method (it's all weight loss and surgery). Leaving that aside, this says:

Is remission permanent?​

We have reports of people who have been in remission for up to 15 years. However, even if you are in remission, it is always possible that your blood sugar levels could come back into the diabetes range.

Remission is not a one-off event, but a process. It needs to be maintained, and the best way to do that is to keep to a healthy weight and stay active.

So what they mean is that they know of people right now who have been in remission for 15 years. It doesn't imply that something changes and will stop them getting to 20, and 25, and whatever.
 
maine1965 said:
Looking for advice on how to proceed forward from remission...How to maintain it long term?
Click to expand...

If you get there congratulations. Continue your lifestyle.

I’ve never managed a hba1c below 43 despite full Keto for the last 5 years
 
maine1965 said:
Hiya Ian, I found out a few weeks ago once diabetic that remission is possible for up to 15 yrs
Click to expand...
Only long term data you'll find on T2 remission comes from bariatric surgery.
Look up the Swedish Obesity Study, large cohort still in remission 15+ years after 20-30% weight loss.

maine1965 said:
I actually thought I could totally get rid
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Only evidence you'll find of T2 "recovery" (loaded term) is in obese T2s who's diagnosis is picked up early, normally at a low diagnostic level & implement huge diet/lifestyle changes that result in dramatic weight loss. There are a few unicorns out there who could pass every diagnostic test, FBG, HbA1c & OGTT, I would be one of the few & I can tell you there's no getting rid of the Sword of Damocles, my weight maintenance needs to be for life, age will undoubtedly play a factor in the future & can I keep up exercising into my 70s/80s.

I will give you some longer term hope though, I correspond regularly with a T2 couple on Reddit. He has been in remisssion for 25 years & his wife reached 20 years last year. They were advised to eat low carb by a medical student friend back in the 90s who told them never to release his name for fear of being struck off.

Another regular poster had a grandmother diagnosed in her 60s, she recently reached her 33rd year of remission near her 95th birthday, she's not low carb but lost about 20% of her weight early days & kept it off. She enjoys a scone every morning before her regular walk.
 
I pretty much agree with previous posters. I've been in remission for a couple of years now but do not intend to go back to eating a higher carb diet as I fully believe I will then move right out of remission.

I don't spend a lot of time worrying about how long I can stay in remission. By staying very low carb I am doing everything I can possibly do. If/when the day comes that my diet alone is insufficient I will need to consider what else I need to do.
 
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