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Indicators of Remission To Look For

oldnevada

Well-Known Member
Messages
728
Location
Montreal, CANADA
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Sugar, in all it's iterations.
Hello Forum,

My BG levels have been very stable for quite a while now. Even when I come back from a 45min jog, my BG is like 6.1mmol/L. It used to be 7mmol/L and my GP told me that was normal. But now it's constantly in the very low sixes. I'm on Komboglyze (Saxagliptin.)

I've also been losing weight, so much so my neighbours as noticing.

I hear of diabetics posting they have gone into remission, lost like 50lbs or more. I ask one nurse in our medical system and she said I'd never go into remission, which, it what I understood. But i'm seeing all these incredible success stories and wonder if I'm setting myself up for one.

If true, what should I be looking for? Thanks, all.....
 
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I regard it as having two years of HbA1c tests below the threshold for pre-diabetes, so under 40. Also testing regularly and seeing no major spikes after eating, with readings allbelow 7. Though that isjust my personal opinion, and others will have their own.
 

Remission is a debatable term. I know my GP won't call it that, she just says I'm well controlled through diet. Qualifications vary per person. To me, I didn't call it remission until I was medication free and consistently in the normal range for a few years, but that's just me. It's not so much about your bloods being stable, it's more a matter of, can they stay in the normal range without medication? (Again, my personal qualifications.).

So, what to look for.... Well, the medication you're on now forces your body to make more insulin. If you don't need the meds to do that and you can stay in the normal range without it, then yeah.... I'd call that remission. If it's the glip, and that alone, that's keeping you in range though, then no. If your medication is doing all the work, and you seriously, absolutely need it to control your blood sugars, then it's not remission.

You haven't mentioned what you're eating, just the jogging... Is that how you lost weight, or was it ombined with a diet, and if so, which one? Any chance of cutting (more) carbs? Or did that have insufficient effect and that's why the glip?

Good luck!
Jo
 
It is debatable, but the main criteria is to have non-diabetic HbA1c results for a couple of years, together with no medication to help you along (Maybe apart from Metformin), plus pre and post meal levels all or mostly within non-diabetic ranges.

Levels after exercise are not good indicators because some people find they increase, and others find they decrease. It is what happens after eating that count.
 
Yes, another thing to beware is that sometimes ‘remission’ is not permanent.
I achieved non-diabetic levels in 2011. My GP wanted to declare me ‘diabetes resolved’ and remove me from the surgery diabetics database. I asked to remain on it, and he agreed, as I had family history of diabetes, (paternal relatives and siblings) I wanted to make sure of having the retinopathy checks etc . Two years ago my HbA1c level crept up again, and I have struggled to reduce it again.
 
I would consider it to be medicine free and with all blood tests within the normal range for at least a year.

Even with normal tests for two years now I am still classed as T2 by my doctors and have annual blood tests, plus eye and foot checks.
 
I always think of it like having a glucose intolerance, it's always going to be there because of a 'flaw' in your make up. If that wasn't the case then everybody who fitted the so called (and ignorant) type 2 profile would also have diabetes. Having said that if you can keep it in check then it's as good as being cured but I guess you have to be careful that you don't go above your personal threshold or that kink in your system will likely kick in again. x
 
Hi @oldnevada, Since the gliptin can have a decent sized effect on your BG levels, then I don't think you are that close to being in remission. There are many different definitions used for remission - almost as many as there are studies of T2D's in remission. The easiest of these to meet is having 2 x HbA1C tests at least 6 months apart with levels below the threshold for T2D ( so that allows pre-diabetic range) and having done that with no diabetes medications except for Metformin.

The toughest definition is 2x normal range HbA1C tests 1yr apart and having done that on no diabetes medication whatsoever.

I don't think it matters which definition you use or whether you call it remission or not. If you need no diabetes meds (except possibly Metformin) and can consistently control your BG to be below 8.0 mmol after meals and have an HbA1C below the fully diabetic range, then you will be a winner!
 
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I have had non diabetic Hba1cs for approx 7 years and, despite me considering myself to be in remission, my DN tells me that I am not in remission just very well controlled.
 
I think there may be people who believe they have achieved remission once the have had a single non-diabetic result. But it's essentially a matter of keeping results at a normal level without the aid of any diabetic medication - long term. Otherwise it's essentially being well controlled - which in itself can be no mean achievement.
 
Oh yes, in the early days I believed I had ‘reversed’ my T2. Depending on how one wants toninterpret that, possibly I had. Until I had more experience it hadn’t occurred to me that the possibility to put T2 into ‘forward gear’ would always lurk.
 
Thank you for all the in depth feedback folks..! (I was thinking that if I started having hypos on the komboglyze would be a non medical indicator.... anyway, I'm due for another blood work in Oct. I turn 68, I can't believe I've made it this far!! Doing something right....!!) Must remember to ask Dr. K. for my HbA1c this time.

@JoKalsbeek:
I low carb, Jo. I try and am somewhat successful at keeping my carbs at around 120g carbs/day. (I've been following Dr.Becky Gillaspy for guidance.. but I'm not into keto. )
 
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Three months after being diagnosed T2 in April 2013 (Hba1c 10.7), thanks to weight loss ( 20 kg), excercise and diet only I got back in the non diabetic range. Metformin only for the first two months and then I stopped and refused any medication myself. Since then ( my Hba1c and all my readings, they’ve been in the non diabetic range. (4.1-5.1 fasting and postprandial never higher than 6.5) Though my NHS only allows 100 strips per year, I subscribed a strips and lancets plan with ONE DROP and I test 3 to 4 times per day. During these years the Hba1c variations went from 4.9 to 5.4. I’m not a strict low carb person and I occasionally have sweets and icecreams (two or three times a week). I don’t know if you can call this remission, but to me that’s pretty close to.
 
Well, if you ever want to try dipping lower so you can cut back on the medication, 120 means there's still wriggle room to do that. And if you're happy with the way things are, as you are in the normal range now as it is, then you just keep at it!
 
Is Metformin not a diabetic medication by my understanding of the contributions of both @Bluetit1802 and @ianfOster on this thread? Thanks
 
tayelola said:
Is Metformin not a diabetic medication by my understanding of the contributions of both @Bluetit1802 and @ianfOster on this thread? Thanks
Click to expand...
It is, but it doesn't possibly cause hypo's. Met makes your liver dump less glucose (usually in the morning), makes you a little more sensitive to your own insulin, and makes you feel less hungry. That's about it. Other meds can force your pancreas to produce more insulin, and when on low carb, it could be making more than you actually need, resulting in a hypo. Just all depends on what your meds do. (People on metformin don't have to test before they drive. Those on insulin or gliclazide for instance, have to. Otherwise there could be insurance trouble, should you crash when low. "Five to drive" is the rule of thumb, I gather.)
 
tayelola said:
Is Metformin not a diabetic medication by my understanding of the contributions of both @Bluetit1802 and @ianfOster on this thread? Thanks
Click to expand...

Yes of course it is a diabetes medication, but it also used for other complaints. As far as diabetes is concerned it is very mild and only helps some people, and then only to a limited extent.
 
My definition is no medication, no hyperinsulinemia and no hyperglycaemia. But I wouldn't pay too much attention to the views of others in this regard. Do what's right for you and keep getting better. In time your own goalposts will shift anyway. Small moves.
 
Grateful to you all for the useful comments.
 
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