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Is "Reversed" the same as "In Remission?"

I think you will always have diabetes, think they are the same... reversed as in = normal range again and remission as in = you’ve got it back in normal range again.
Like most things it’s keeping it there!
P.S if you have yourself got normal levels massive congratulations as it takes lot of work and willpower! X
 
Yes, indeed. It takes a lot of willpower. I have done it.
HBA1c 37 for the last year. No Meds.

I wish I knew years ago what I know now, it has taken a long time until I have learned what must be done.
Cannot let up, because if you do, it will come back again and I don't want that to happen.

Low carb < 30 grams per day, so you must watch what you are eating.
It has to become a lifestyle, rather than call it a diet.
A diet usually comes and goes. This is different.

A good side effect is also weight loss.
 
Me and my GP prefer very well controlled for my non diabetic HbA1cs, however I use Remission here on the forum as it’s the closest available to what I feel is true. Reversed sounds somehow permanent, while Remission has an element of a temporary state. In the case of my type 2 is will only remain in Remission if I carry on with my current lifestyle
 
I am officially in remission, but I think I spent too many years eating healthy carbs to drop down into the normal range from the top edge - even on under 40 gm of carbs a day my 'glucostat' is set too high.
Some people can reverse right down into the 30s, and I don't think I will ever do that.
 
My doctor has me classified as "well controlled" which seems a good description to me. Reversed sounds like I used to have too high blood sugar and now it is too low.
 
Listlad said:
I like to use the expression “symptom reversal”.
Click to expand...
This question cropped up at PPG level where GPs from two surgeries expressed a dislike for the term remission on Debandez’s leaflet. I suggested symptom reversal as an alternative (there had been talk of editing the leaflet somehow) and those at the meeting including one GP seemed to find that palatable.
 
My diabetes status, on my GP medical records states "Diabetes Resolved"

I was diagnosed in October 2013, with an A1c of 73. The following February (3.5 months), my A1c was 37. I have never been higher that 33 since, with my last, my last at 27.

Conversations on remission, reversal and cur on here can become heated. To my knowledge, only the ADA has been bold enough to mention cure, in their paper, here: https://www.diabetesremission.org/our-task .

“Our Answer”
The IDDR is being developed to identify the factors, levels and interactions that increase the probability of remission in a person with diabetes. The goal is to enable the deployment of novel solutions as fast as possible.

Our first paper is being prepared, here is the abstract:

Background
The Diabetes Remission Project (DRP) aims to develop a protocol for remission of diabetes. Remission status is operationally defined as being able to sustain regular blood glucose levels (HbA1c < 6.5%, fasting serum glucose < 125 mg/dL) without requiring ongoing pharmacological or surgical treatment. The project has an observational, an analytical and an experimental component. This paper describes the initial findings from the observational component. Results from the analytical component -using statistical learning and large databases- will be available shortly after abstract submission, in May 2018.


Aims
To identify the factors that maximize the probability of sustaining remission of diabetes, with special emphasis on non-surgical and non-pharmacological strategies.


Methods
Cases of remission are identified worldwide, using clinical referrals, online forums and social networks. Participant’s non-pharmacological strategies are explored with three different approaches. Close-ended surveys are used to obtain sociodemographic data, proof of physiological condition and a brief description of non-pharmacological strategies. In-depth interviews are used to deepen on understanding the dietary, physical activity and psychological strategies utilized to sustain remission. Ecological momentary assessment and smartphone data donation is used to collect quantitative data on diet, physical activity and to collect pictures of participant’s food, and physical environment. A mixed-methods assessment is then utilized for cross-reference and quantitative assessment. Special emphasis is given to find a novel or recent physiological hypothesis on how to sustain remission.
Smartphone data donation. To perform this activity, we use of a platform that guarantees data donation in anonymity. In addition, donors can keep record of their donations using a blockchain-based registry. This system was built by Bitmark, Inc.


“Definition of Diabetes 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 mor
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/"

Based on the foregoing statements I am operationally cured. I like to think I review that on a daily basis.
 
Looking at the definitions above the status of my T2 now ‘Operational Cure’ however according to my DN I’m not even in remission!
 
I don’t currently have diabetes but it may return in the future if I ever revert to the ‘healthy’ way of eating that brought it about in the first place. Since I never intend to do this, I’m happy. Terminology and semantics are of minor importance to me. What is of major importance is that no blood test I could take will bring about a diagnosis of type 2 diabetes. I have low glucose, low insulin, and low HOMA-IR relative to my current diet. Job done.

Others prefer a different outlook and that is their prerogative.
 
Another way I tend to refer to it is that “my blood sugar levels are good”.
 
To answer the question, remission in the UK is a recognised NHS status, not sure about other jurisdictions. My surgery required my HbA1c to be below 42; however I note remission several recognised establishments is in the pre diabetic range.

I have to ensure I stay out of hospital, as this is the only way high carbs would get into my unconscious body.

I intend on doing what I have done for the past 4 to 5 years. I am cured of carbs which in my case caused Type 2 so that's that then.
 
Well, I reject all the above classifications and prefer diabetically divorced.

Carry on.....
 
James is officially "Resolved". We are happy with this. We found that he had a problem (very high sugar levels, tired, thirsty, peeing lots, retinal damage etc). We worked out what caused the problem (too many healthy wholegrains). We stopped eating most carbs/sugars, problem solved. That was over six years ago. No diabetic numbers since. Even the retinal damage has gone.
Sally
 
Regardless of type, can you count it as either if you can’t eat a diet that includes what is commonly regarded as a “normal” amount of carbohydrate without you blood sugars going out of a healthy range? I’d say not. If you can’t eat carbohydrate without getting high BG then you still have diabetes.

Food is medicine;
Medicine is medicine;
Insulin is medicine.

If you have to adjust any of these things out of line with what you did before diagnosis, then in my opinion you still have diabetes.

I went to my consultant on Friday to get a Dexcom, and she was concerned about my low Hba1c of 35, so I showed her this 3 month average chart that covered that period (to assuage her worries of too many hypos) and she actually said “you’ve cured your diabetes!” - to which I replied, sadly not but I do work very hard and make a lot of food sacrifices to manage it.

Non-diabetic levels do not mean you are cured of diabetes - just that you’re managing the condition (of whatever type) with food and/or medication. If you can’t eat whatever you want without your levels going silly, you’re still diabetic. Well managed isn’t cured or reversed.

 
LooperCat said:
Regardless of type, can you count it as either if you can’t eat a diet that includes what is commonly regarded as a “normal” amount of carbohydrate without you blood sugars going out of a healthy range? I’d say not.
Click to expand...

I'd disagree that what is commonly regarded as "normal" should be.. highly processed junk should never be considered normal.. neither is it species appropriate for humans.. but thats just me I guess...
"Humans the only species smart enough to manufacture their food and stupid enough to eat it?"
 
Humans have eaten grains and root vegetables for millennia. Junk food is an incredibly recent phenomenon.
 
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