Is T2D remission rare?

[kokhongw]

Posted a similar question in the T2D forum. But I think this might be a better place to get the numbers

"Researchers found when they analyzed data from 122,781 adults enrolled in a health care delivery system. Seven years post-diagnosis, only 140 of them had ever achieved complete remission, defined as having an A1C (a measure of overall glucose control) of less than 5.7 percent on at least two visits without taking any diabetes medications. Only 6 people maintained remission for five years straight."
http://www.diabetesforecast.org/2015/jan-feb/remission-rare-possible-type-2-diabetes.html
http://care.diabetesjournals.org/content/early/2014/09/12/dc14-0874.abstract

Thanks.

 

[Mep]

I would think remission would mean that the same people achieving good hbA1c are able to eat whatever they like without having to control their carb intake. If they're controlling their carb intake then their diabetes is really diet controlled, not in remission. I did that myself for at least first the 5 years after diagnosis and then the next couple years didn't get the perfect numbers and eventually put on medications, etc.

 

[4ratbags]

coming up to 2 years and only time will tell. I find Im okay as long as my depression only comes and goes, the last bout lasted 6 months so the next Hb test will tell if any damage has been done through eating normal food on and off for that amount of time.

 

[Hiitsme]

I'm only 18 months into this so no idea of long term for me but will try to keep as tight control as I can. I do have a concern that not all type 2's are able to control without medication. For example if there is damage to their beta cells then however hard they try it is unlikely they can manage without medication. This forum needs to support all diabetics and for some medication will be needed and I would hate people to feel a failure when it's not in their control. I feel at the moment I'm one of the really lucky ones who have managed to control on diet and exercise but I have no idea how long this will be able to be maintained.

 

[Indy51]

I guess if I keep up the good work till March 2017, I could claim "remission" - but it's not a term I like to use. I'd rather use "diet controlled".

My results from diagnosis: 12/3/12 – 6.2%
19/8/12 – 5.5%
1/3/13 – 5.0%
2/9/13 – 5.7%
5/3/14 – 5.2%
1/9/14 – 5.5%
21/1/15 – 5.5%
25/8/15 – 5.4%
25/1/16 – 5.2%
27/6/16 – 5.2%

 

[kokhongw]

I pretty much agree that the real definition of full remission should include restoration of phase 1 insulin response that allows normal response to a carb loaded meal. Those of us who have return to sub 6% knows very well what a carb loaded meal will do to our glucose level. But then even with the relaxed definition using only HbA1c < 5.7% for 2 visits, the numbers are already shockingly low...a dismal 140 out of over 120000.

 

[Mep]

Yeh I think I get annoyed with reading "I'm in remission" and then they talk about how they're controlling their diet, and doing this and that exercise, taking this supplement and that, etc. Well if you're in remission why would you have to do anything? Being in remission is really the disease being dormant. Eg. with cancer patients after they get the all clear after treatment. I have other diseases that supposedly can go in to remission too (I wish mine would). My understanding from others who claim they've been in remission before (with my other diseases) and come out of remission is that when in remission they ate whatever they liked, exercised as much as they liked, did things that would normally put them in a flare and it all did nothing negative to them at all. They felt good no matter what they did. They stopped experiencing the symptoms basically. Whereas now that they're not in remission, they eat the wrong thing, do the wrong thing and they know about it pretty quick. There's no harm saying I'm controlling my disease with diet. I think most people achieve that for some period of time at least. Some can achieve it over long periods as @Indy51 has given us proof of. I think the term remission should only be reserved for when you're not doing anything to control the disease yourself and you have no effects or symptoms from doing so either. Ok, sorry for the rant. lol. But it is something that does get to me as it gives a false perception to those who don't have the disease themselves thinking well if you say you're in remission, then everyone else should be able to achieve that.

 

[4ratbags]

Rant away @Mep I agree with you totally. I have been guilty of using a few terms myself and looking back I now realise that 'diet controlled' is what I am comfortable with.

 

[Pinkorchid]

I agree with Mep when people say they are cured or in remission they would no longer have to control their diet but could eat what they liked not take any medication and live their life just as they did before they had diabetes. How many can actually say they can do that. Because we are different people I think we all have a glucose level that suits our body best and where we can say our diabetes is controlled .. I know for instance my T2 neighbour says if his BG drops below 10 he feels unwell so tries not to go below that so I imagine he thinks he is controlling his diabetes for others that would be much to high. My T2 brother-in-law lives in Sweden and he says as long as he takes the Metformin he was told he can eat anything he likes and does not have stop anything because that is what the Metformin is for. Just shows how people have different opinions.We can't generalise on what level the HbA1c should be that we should all try to achieve as it is different for everyone

 

[JohnEGreen]

This evening I ate a cheese burger with fried onions and burger sauce and potato wedges quite high in carbs after an hour BG level 6.8 after 2 hours 6.1 is that remission I wonder it may be it may not be but after loosing over the last 12 months 7 stone in weight and reducing HbA1c to 38 I think that there is a good chance that it is I hope so.

Non the less that meal is not going to become the norm for me, as in the time I had uncontrolled diabetes I developed complications and though I tend to stay in the normal range I still will have to monitor and keep BG as low as possible to try and reverse the damage done. Does that negate the remission? my doctor believes I'm in again may be so I just don't know.

 

[AndBreathe]

OK, I'm going to be controversial here, but that's me.

Why, why, why,......... thrice I say why, do we get tied up in labels? Why do we worry if we're in remission, reversed, cured or in great control? Does it really, really, really matter what the label says? It doesn't in my universe.

How many of us, in our day to day lives, talk about how we manage our diabetes and tell people we are "in remission/resolved/cured"? How many of us are more inclined to be getting on with out lives, doing as well as we can? (Rhetorical)

From my own perspective, my immediate family are obviously concerned I continue to do well, but my wider community beyond? They have their own issues to wrestle and as far as the big D is concerned? It might as well be the woman in the village newsagent, called Doris. They want me to be, generally well, and functioning within our mutual community. They don't have any more of a robust handle on the consequences of running fast and loose, with blood sugars, than I really did, deep down, at diagnosis.

My HbA1c has been 37 or less at all points since February 2014 (4 months post-diagnosis) and intend to remain in this region for as long as I can, whilst living a good, flexible, happy life. Along the way life's event will step in. Stress will occur. Illness may happen. There'll be physical and emotional highs and lows, but as much as I care very much what happens to people on here (and I do care, in my own way), the stark reality is we can only look after ourselves and look out for others. I'm no good to others unless I'm doing the right thing by myself. As my profile pic suggests, you can'r drink from an empty cup.

My aim goes way beyond 2 years, and similarly on the 5-year-and-beyond time frame, but, and it's a big but, if it doesn't work out, I will have given it my best shot, without deferring my fun and adventures, nor will I have shelved my "joie de vivre", in favour of something I may or may not be able to achieve.

Rant over.

Er,............ I may have mentioned in the past I really do detest labels.

 

[James Higher Strength]

It seems like people are forgetting here that humans are not designed to eat what are considered to be "normal" volumes of carbohydrates (bread, grains, pasta, veg that grows beneath the ground etc). This is the reason why T2 diabetes is an epidemic growing year after year. We are 300,000,000 globally at present. The outlook is that by 2030 it will be 500,000,000 and by 2300, the entire human population of the planet will be diabetic if this type of consumption continues. Do these figures not scream - "hold on, there is something very, very wrong here!?"

In this instance, I disagree with people when they say "what works for one, may not work with another". This is like saying, "water doesn't agree with me". Diabetes is not a psychological condition. Our bodies are mechanical - machines with a computer running it - the brain. Our machine and its' systems require identical nutrition to function, akin to cars needing oils and fuels. Social conditioning and flawed conventional wisdom, passed down through corporate bodies, government, the education and health-care systems has removed simple truths. There is a mountain of misinformation out there designed to trap, confuse and ultimately - enslave.

My advice is to keep it simple. Try and emulate our eating and movement patterns of our ancestors and try not to succumb to all the false claims that have been engrained into "conventional wisdom".

 

[Mep]

It seems like people are forgetting here that humans are not designed to eat what are considered to be "normal" volumes of carbohydrates (bread, grains, pasta, veg that grows beneath the ground etc). This is the reason why T2 diabetes is an epidemic growing year after year. We are 300,000,000 globally at present. The outlook is that by 2030 it will be 500,000,000 and by 2300, the entire human population of the planet will be diabetic if this type of consumption continues. Do these figures not scream - "hold on, there is something very, very wrong here!?"

In this instance, I disagree with people when they say "what works for one, may not work with another". This is like saying, "water doesn't agree with me". Diabetes is not a psychological condition. Our bodies are mechanical - machines with a computer running it - the brain. Our machine and its' systems require identical nutrition to function, akin to cars needing oils and fuels. Social conditioning and flawed conventional wisdom, passed down through corporate bodies, government, the education and health-care systems has removed simple truths. There is a mountain of misinformation out there designed to trap, confuse and ultimately - enslave.

My advice is to keep it simple. Try and emulate our eating and movement patterns of our ancestors and try not to succumb to all the false claims that have been engrained into "conventional wisdom".

That sounds mostly good in theory, but our ancestors also ate badly. If you look at the UK royal family for example, King Henry VIII is thought to have had type 2 diabetes because of his bad diet. He suffered from really bad leg ulcers. They say he ate a lot of white bread, fatty meats, and he loved strawberries. He didn't eat much else that was healthy such as vegetables. So I wouldn't say all our ancestors ate well. Diabetes has been around a while and I'd say type 2 isn't a new disease, although I'd agree it is probably more rampant.

As for as "what works for one, may not work with another", I'd say that would be true because we don't all just suffer with diabetes here. I have a limited diet myself because of other health conditions. So what works for me will not work for the next person who has a totally different health profile to me. I'm sure there are other factors that would influence how we respond to the disease as well such as environmental, economic, etc.

 

[James Higher Strength]

That sounds mostly good in theory, but our ancestors also ate badly. If you look at the UK royal family for example, King Henry VIII is thought to have had type 2 diabetes because of his bad diet. He suffered from really bad leg ulcers. They say he ate a lot of white bread, fatty meats, and he loved strawberries. He didn't eat much else that was healthy such as vegetables. So I wouldn't say all our ancestors ate well. Diabetes has been around a while and I'd say type 2 isn't a new disease, although I'd agree it is probably more rampant.

As for as "what works for one, may not work with another", I'd say that would be true because we don't all just suffer with diabetes here. I have a limited diet myself because of other health conditions. So what works for me will not work for the next person who has a totally different health profile to me. I'm sure there are other factors that would influence how we respond to the disease as well such as environmental, economic, etc.

My phrase "Ancestors" refers to 10,000 years ago - hunter/gatherers. Our primal, natural state in tune with "mother earth". It is pretty much guaranteed that if you drop carbohydrate levels to approximately 50g or less per day - and these carbs must come from good sources - real food that was available to us in that period, will lower blood glucose and eventually put the body into its' natural fat burning state. They did not have white bread (sugar), nor an abundance of sweet fruits year round. They had what they hunted and foraged. They lifted, heaved, walked, rested, played. They did not sit at desks eating rice heavy or grain heavy meals. They were physically superior to us in strength, muscle composition, speed and dynamics. All these traits were down to their lifestyle. Yes, some died young - but these were usually brought on from wounds in the hunt or an injury sustained, natural selection etc.

There are 2 books I highly recommend:

1. The Primal Blue Print by Mark Sissons - Very in depth and empowering book.
2. Diabetes? No Thanks! by Lars-Erik Litsfeldt - Easy to read and instantly helped me.

Try to emulate living this way for a while and notice the changes. Once one can feel and see the fantastic changes that occur once this type of lifestyle is adopted, I would hope that one would continue this way rather than succumb to the modern status quo.

 

[ickihun]

I'm coming to the conclusion that D can make you unhappy and guilty for what has been conditioned psychology. Sociology is much much more.
Get the dynamics right and all planets in alignment for 2 hba1cs to be spot on? Yes some are within our control. Like what and how much we put in our mouths. Let's do our bit and hope for the best. Longevity for all.
Ps. What about those diabetic who have been now noted as no longer diabetic? Were they included in the 140 lucky winners?

 

[ickihun]

I wonder how many of those 140 had a 3rd excellent hba1c result or fell out of 'remission'.
Or do you only get 2 before your dismissed from nhs care?

 

[ickihun]

I hope @PenfoldAPD sees this as he was wondering how everyone states they're in remission on no meds but we are finding it near on impossible. I've told him some are having us on. If all posters who are in success stories had no meds and 2 excellent hba1cs then it would be more than 140, by far. I'm realistic, always have been. Accept what you can change but accept what you carnt for your own sanity, if nothing else.
I don't mind searching for the golden chalice so I can have it's knowledge. Maintaining it for a lifetime? - like in football, not even fergie could keep the trophies for a lifetime. Now that is the true fallacy!
I bet far less than 140 can keep up lifetime maintanence.
This doesn't mean give up and go to bed and stay there. Do YOUR bit and keep the demon (complications) abay!

 

[Brunneria]

In this instance, I disagree with people when they say "what works for one, may not work with another". This is like saying, "water doesn't agree with me". Diabetes is not a psychological condition. Our bodies are mechanical - machines with a computer running it - the brain. Our machine and its' systems require identical nutrition to function, akin to cars needing oils and fuels.

Totally disagree.

There are so many variables between individuals (genetics, environment, climate, food reactions, levels or organ function, medical histories) that statements like this are just hyperbole. The statement is far too generalised and idealistic to be applicable in the real world.

I do agree that generally we do better when we approach 'our ancestral diet' (although I often find that phrase counterproductive too, especially when used in a Paleo Blog Rant).

Regarding the subject of this thread, I have no interest or expectation of personal 'remission' so I try not to get involved in the discussion to much - except for one aspect - and I am like a stuck record on that It saddens me tremendously to see people who work so hard, and put themselves through the toil and effort and deprivation of extreme diets, only to find that they can't reach the goal, because it is no longer within the physical capacity of their body to get to that point.

It must be so dispiriting. My attitude is to make sustainable changes and sustainable decisions, and not subject my body to extremes. Ever since adopting that view, I and my body have lived together in a much happier and more harmonious state.

 

[tim2000s]

Whilst I'm not a type 2, given the prevailing view regarding what you should eat and how T2 should be treated in the medical world, and that the majority of T2s are treated directly according to those models, it should come as no surprise as to the numbers being presented.

Given that the only way, currently, to reverse T2 seems to be to do exactly the opposite of what your HCP tells you, which many people are very uncomfortable doing, it's perhaps a surprise that the survey found anyone.

 

[James Higher Strength]

My proof is in self-experimentation and thousands of others that live this way - not just diabetics. I cannot speak for everyone as I do not know whether they are falling into old habits and succumbing to the modern addiction, but if one lives a simple, paleo lifestyle with regard to food and movement, there is no doubt physical and mental well-being will improve immensely.

With regard to exercise - Cardio is not the way. Strength training and muscle building is.

My body is my experiment, result and conclusion. I do not live an extreme life, I live a simpler, fitter life than ever before. I limit my choices, which makes things simpler. More than anything, I mistrust the system - this is essential if one wants to succeed.