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Remission is good but is DT2 reversible ever?

G

Glyko

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What does the science say about type 2 diabetes reversal?

I read that reduced fat in the liver and pancreas can reduce insulinresistance and make your t2 improve? I've scrolled NCBI/medline but I'd like to get your views and experiences.
 
Remission from Type 2 Diabetes is certainly possible by using lifestyle (even without any drugs and without any additional exercise). I'm one of over a thousand people in the UK have achieved this (as have tens of thousands worldwide).
Cure implies that if you will still be OK if you then start eating the garbage that made you Type 2 diabetic in the first place. To me this just sounds highly unlikely to happen and also something that any sensible person wouldn't even try!
 
Thanks for the reply.

Well not eating junk but lets say incorporating oatmeal, low carb bread, beans and legumes and fruit and starchy vegs.

It will be interesting to see what scientific evidence there is to reversal..

Congratulations by the way to your remission!
 
A normal non-diabetic eats 300-350gs of carbs per day & has an A1c of 5.1% (32).

I had a low diagnostic level 6.9% (52).
I lost 5st rapidly, slowly increased carbs as per my meter & passed an OGTT 14 months post remission.
I've had background retinopathy & self diagnosed neuropathy, both of which have cleared up thankfully.
Was it a fluke, am I a unicorn ???? . . . who knows.

There's is no common diagnostic test, FBG, HbA1c, OGTT, that I would not pass with flying colours.
I ate 100-200gs of carbs per day while wearing a CGM back in may & it estimated an A1c of 4.5% (26).

In June of this year an Endo offered to remove my diagnosis, I still haven't accepted it nor do I intend to.
Remission/reversal are only words, they are not a blank cheque to resume your old habits, that is gone.
Grieve that share bag of Doritos, look longingly at the Snickers Bar on your way to the till, but they are gone & can never enter your thinking again.
 
I try to keep current on anything related to T2 from diagnosis levels (HbA1C) in different countries, internationally agreed remission criteria, paths to remission etc. I have never come across any actual medical study which says that says a cure is possible. In fact the majority of GP's have never seen a single case of remission, much less a patient being cured.
Though I have seen evidence of Type 1 diabetes being cured - but only by a pancreas transplant!
 
I don't claim "Remission" but I've been T2 for just over 8 years and apart from the first few months have kept my glucose at high normal-lower pre-diabetic levels by eating a (IMO fairly liberal) low carb diet, generally under 50g carbs a day. I've not needed any diabetic meds since 2017.

I've spent most of my life eating a moderate carb, normal full fat, diet and it was eating too high carb diet for a number of years that was one of the causes of my diabetes, so as long I can avoid those extra carbs, unless my ancient pancreas and liver give out, I see no real reason why I can't remain pre-diabetic.
 
Living proof here that slipping into old ways doesn't work!

Got my hba1c from over 100, got it down to the 30s and kept it there for a year.

Things slipped - not on purpose and with that my bg has gone up and up again.

I know that's common sense really, that lots of carbs won't keep you down. But even as they were creeping up with some more healthy carbs the destination was locked in and it was hard to back track. That included lentils and beans. But I think the introduction of carbs triggered my brain.

For me, a lentil became a chip became 5 chips, became a packet. No wonder it went up!
 
I had been on a 'cholesterol lowering' diet before diagnosis - the grain and potatoes etc were all considered healthy, but they are just as much carbohydrate as sweets and cake. They are also very fattening. I was almost spherical.
 
I have a nuanced view to some of the other comments. I never follow the crowd anymore, or mainstream "experts", as my food choices got me a 134. I look at what normal really is, not what I am told. When I was 10 even on a council estate there was a butchers with saw dust on the floor a animals in the window = normal; now a 10 year would recoil in digust.

I believe persons such as Ivor Cummins, Dave Feldman and Ted Naiman, who approach food habits with the forensics of a technical background and an open mind have help shatter what is normal with a mathematical / technical approach compared to science. I also thought science had an explicit mathematical basis e.g. 1 add 1 = 2, but experience in the food sector has taught me that science aligns with commodity products.

If you follow the science for Type 2 reversal, you will just eat less move more, high carb, low fat, animal food as a condiment. If you follow the technical people it will essentially be meat and 2 veg on a spectrum.

(mod edit for strange glitch or cat on keyboard)
 
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In my opinion diabetes is either there or it isn't. If you can't be clinically diagnosed then it's gone. I broke my ankle once and I'm sure I could manage it again if I tried. An inability to deal with carbohydrate is not diabetes. Diabetes is what happens when you continue to eat it anyway. I think one's perspective depends on whether or not you think eating literal kilos of glucose every week is a normal human diet. If you do then you're going to be forever disappointed.
 
My take is that there are gazillions of people who eat whatever they like and don't develop diabetes, and therefore are not diabetic. There are loads of people whose BG would present in the diabetic range and sustain this if they ate a normal diet (however healthy or unhealthy that diet might be) but goes into remission if they are very careful with their carbs/sugars or go ketogenic. These people will always be "diabetic" in that the potential is always there if they don't regulate their diet. But if they do regulate their food intake (by type not amount) they can consider themselves in remission as long as their BG remains at non-diabetic levels.
 
Glyko said:
What does the science say about type 2 diabetes reversal?

I read that reduced fat in the liver and pancreas can reduce insulinresistance and make your t2 improve? I've scrolled NCBI/medline but I'd like to get your views and experiences.
Click to expand...
Yes you can "make your T2 improve". Many people on here have done it. It depends however what you mean by "remission" and "reversal". I take remission to mean A1c in normal range (see graph for what normal is, HbA1c around 38-40) without meds over a period of time. Under that definition, I am in remission.

If reversal means remission as above plus the ability to eat as many carbs as you like, then I don't think that is possible. From my own testing I know that the few times I eat any quantity of carb my BG rises disproportionately, and it would be easy for me to get back to "official diabetic" levels in a few months maximum. I'd just need to adopt the "Eatwell" style of eating. Obviously I'm not about to do that.
I
 
Hi! Did you get any treatment for retinopathy? Was there any bleeding? And do you see clearly now? How is your vision? Thanks
 
Glyko said:
What does the science say about type 2 diabetes reversal?

I read that reduced fat in the liver and pancreas can reduce insulinresistance and make your t2 improve? I've scrolled NCBI/medline but I'd like to get your views and experiences.
Click to expand...
Remission, yes. "Cure", no.

I was diagnosed in 1996. Once I learned how, I kept my blood sugar mostly within normal parameters through food choices and exercise.

...and then...

In 2019, I fell and sprained both needs. My walking routine became impossible for months. As I was healing enough to get up and down the steps into my home, and was trying to restart my walking, COVID-19 hit and we were on lock-down. I was “allowed” to walk for a limited time in my neighbourhood, but I couldn’t return to my favourite walking park. By then, of course, I had developed many, many sedentary hobbies and opted to be lazy.



I still walked a fair bit in the course of errands because I don’t have any personal transport, but I never returned to my ambitious walking routine.



Then lock-downs and masks were over, and of course, I caught COVID19. That was “just” a flu like condition for me, But the post viral syndrome (Long COVID today, yuppie flu last time I had it in the ‘90s) was no picnic. For 13 months, just my normal household chores took all day and every bit of energy I had. I managed the 400 metres to the green grocer once a week, but I had to recover for the next 5 days. No ambitious walking schedule for me.



To accommodate, I tried cutting my carb lower and lower. It didn’t help much. I went from the 5% club to readings of 7.0-9.0 with FBG of 10 or 11 sometimes. My doctor finally acknowledged that I do indeed have diabetes. (win?) and for the first time in all these years, I started to develop complications, such as retinopathy.



I knew all along that I needed to get back to my more active lifestyle, and I was working a long walk in as often as I conveniently could, but it wasn’t enough. Neither was a keto diet. (It works well for many people, but keto seemed to make my hypothyroid worse and started to cause my energy levels to flat line.)



The shorter version – 23 years of “remission” erased in a few years of failing to care for my health adequately. So here I am, back again to learn all that has been discovered since my last foray into the diabetes UK forums and to get reminders of why those 45 minute walks are more important than almsot any "urgent" matter that might tempt me to skip them.
 
Responding to Post#3 in this thread, my take on it is that science has not yet uncovered or identified any specific cause or effect that is a proven trigger for T2D. There are many hypo(theses) as to what is the root cause or efffect, but nothing to hang a definite hat on. Until we understand what causes T2D, we are left with dealing with the symptoms, and hopefully minimising those to attain a reasonable quality of life.

Personally, I am happy to have been diagnosed with this conditon - there are multitudonous other conditions that are worse and often terminal. At least I get my bloods analysed annually, and I get health checks free and frequent. I have the means to monitor my health to a deeper understanding than most 'normal' people do, and I get to be able to change my lifestyle to help keep me fit and active, which at my age is often a severe challenge for even normal people.

Speaking of challenges, your post#3 indicates you may be vegetarian, and in this you will face a greater challenge than me (an omnivore) when seeking remission. I have used low carb to reverse my condition so I can eat those items you want to continue eating, but they come at a cost.

For instance, my daughter got married last week, and she had a vegetarian buffet with vegan canapes. My blood sugars immediately responded with very high sugar levels, and I am only just getting my readings back to the prediabetic level I had been achieving for the last 8 years.

So my 'Remission' is a myth - I am still very diabetic regardless of what my blood readings may say. But i am in a much better place than I was 8 years ago when I first started LCHF.
 
I don't know if you've seen this - international agreement (well, the ADA) on what T2 "remission" is.

Consensus report: definition and interpretation of remission in type 2 diabetes - Diabetologia

Improvement of glucose levels into the normal range can occur in some people living with diabetes, either spontaneously or after medical interventions, and in some cases can persist after withdrawal of glucose-lowering pharmacotherapy. Such sustained improvement may now be occurring more often...
link.springer.com

My practice's definition was a LOT tougher.
 
I am always a bit suspicious of articles from Springer. They seem to be trying to rewrite science, and sometimes their slip shows (i.e. a bias). They bought out the publishing rights of The Lancet, and since then that fount of wisdom has issued some very dodgy material since they teamed up with the EAT consortium.
 
Indeed. For what it's worth, I don't think the definition is tough enough. There's clearly an agenda in play here, but it's interesting to see the "current consensus".
 
Whatever the definition. the NHS is now rolling it out big time for T2D who happen to be overweight and in England.

NHS England » NHS Type 2 Diabetes Path to Remission Programme

NHS England » NHS Type 2 Diabetes Path to Remission Programme
www.england.nhs.uk

I must presume that they are using the DUK definition, but I note that the Tay;lor definition aas used by DIRECT and other studies he did as being different to that adopted by DUK, but again, it is semantics.

Looking after your diabetes

Managing your diabetes, making changes and fitting the demands of diabetes into your lifestyle can be challenging at times.
www.diabetes.org.uk

And for healthcare professionals it is also defined as

Diabetes remission for healthcare professionals

Use these resources and tools to improve your understanding of diabetes remission and how to support your patients. Remission of type 2 diabetes means maintaining blood glucose levels below the diabetes range without needing glucose lowering medications.
www.diabetes.org.uk

/treating-your-diabetes/type2-diabetes-remission
 
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