Remission vs Reversal

muzza3 said:

but that doesn't mean that they are not cured if their HbA1c is normal over successive tests

Click to expand...

It does mean they are not cured if the "successive tests" are only achieved by following a Low Carb diet.

I could have 50 successive HbA1c results of 32, but if I can't also achieve normal BG when I eat a high/medium Carb diet then I'm not cured.

britishpub said:

It does mean they are not cured if the "successive tests" are only achieved by following a Low Carb diet.

I could have 50 successive HbA1c results of 32, but if I can't also achieve normal BG when I eat a high/medium Carb diet then I'm not cured.

Click to expand...

Hi @britishpub
I suppose you would have to eat a high to medium carb diet for several months to test that. But who in their right mind would recommend that anyone (diabetic or not) eat a high to medium carb diet?

If you took 50 successive HbA1c of 32 to 50 different doctors how many would diagnose you with diabetes?

I don't care about calling it remission or reversal. I know that for me personally, if I want to stay feeling well with blood glucose readings in the normal range and remaining medication free I must not go over a certain weight and must continue to eat smaller portions of lower carbohydrate food and exercise daily. The semantics aren't important to me, living a healthy happy life is and I am achieving that with the information I found on this forum.

AndBreathe said:

I didn't think you had dabbled with bariatric surgery, but I had to clarify that this was your informed belief, through research, not experience. Bearing in mind your user name, in particular, new users could consider you have some connection with Prof Taylor and Dr Fung, other than your respect and groupie-dom.

Pedancy? It's just one of those things I excel in.

Click to expand...

Meant bad English on my part xD

Rever

13lizanne said:

I don't care about calling it remission or reversal. I know that for me personally, if I want to stay feeling well with blood glucose readings in the normal range and remaining medication free I must not go over a certain weight and must continue to eat smaller portions of lower carbohydrate food and exercise daily. The semantics aren't important to me, living a healthy happy life is and I am achieving that with the information I found on this forum.

Click to expand...

Reversal and Remission two positive words for a new Diabetic searching the Web for answers to stumble upon and hopefully keep reading

muzza3 said:

If you took 50 successive HbA1c of 32 to 50 different doctors how many would diagnose you with diabetes?

Click to expand...

None, but they would all be wrong.

I would know, which is all that would matter.

Mep said:

Here's my line of thinking..... if you have diabetes solely because of poor diet and being overweight (eg. you have no other precursors to the disease such as other medical conditions, genetics, etc) then you probably can get very good control and keep it that way. Although fasting BGL's is one thing, but what does the BGL's do post prandial? Do they spike at all? All these things would need to be factored in before you can truly say you're in remission if you want to call it that or reversal if you want to call it that. But my words would be you have "good control" for various reasons... eg. you're still eating a good diet, you're still exercising, you've maintained weight loss, etc..... whatever works for you.

There is no cure for diabetes though so I would think if you've been diagnosed then you are still at risk even if you do get good control. You're at risk of high BGLs if you get stressed out, you get sick, you gain weight, you develop insulin resistance, etc. There are so many variables. You're probably still at risk of complications as good control doesn't guarantee no complications ( I think of a family member of mine when I say that... she's dealing with leg ulcers because of diabetes but she has had excellent BGL's... just got a scratch and it got infected, etc).

So to me to say you're in remission or you've reversed diabetes is saying you are no longer at risk of high or low BGL's and you are no longer at risk of complications.

Click to expand...

In my view, there are very, very few who become diabetic as a result of simple weight and diet, otherwise it's hard to explain those who don't. Surely, those who do trip over the line do so because they have "something" those that don't don't? (OK, I think I even lost me in that lot!).

However, the main reason I wanted to respond is your, again, in my personal view, your erroneous understanding of the medical definition of the word "Remission". I quote from various online dictionary, including the good old Oxford:, "
"....a temporary diminution of the severity of disease or pain.
"ten patients remained in remission"
synonyms: respite, abeyance; "

Clearly each of us will apply our own nuance to these emotive words and some will be adopted more enthusiastically than others, but I think those who achieve serial, maintained non-diabetic HbA1cs can comfortably claim to be in remission.

It is my absolute belief that, at diagnosis, patients diagnosed with Diabetes should be given hope. I don't mean unrealistic hopes or promises of cures, but I do mean hope for a decent and fullfilled life where, if necessary, diabetes can be managed alongside the enjoyment of a rich (not necessarily fiscally) life. The messaging so often delivered to newly diagnosed T2 patients that diabetes is a progressive disease and insulin is inevitable. Frankly, on hearing that myself, my response was, "Not on my f'ing planet, thanks!!", and I set myself about finding a way to throttle it by the throat until it submitted.

Of course, not everyone is fortunate enough to have their body recover as mine did and has, but to give no hope, before the newly diagnosed person has even decided where they want to be on the throttling scale, is downright criminal, and could be seen to be contributing to some of the very low mood feelings folks express when they arrive here.

Again, in my view, communication, at diagnosis, is critical to the outcomes for so many T2s. Being told not to ask any questions as he (the Doc) had a lot to get through, at my diagnostic appointment was frankly a disgrace. I still think it's no small miracle he survived. A long planned, long trip, three weeks post-diagnosis meant I was left to my own devices to work out my way forward. I thank my lucky starts for that.

Sorry for the soapbox monologue, but we really do need to be helping people find realistic hope and expectations.

britishpub said:

None, but they would all be wrong.

I would know, which is all that would matter.

Click to expand...

And that is why I say I had symptoms at 6yr old. Maybe my personal fat threshold had been broke, then fixed, then broke again.
I used to train with an international footballer. Everyday. I've took under counter diet pills but only ever achieved 15 stones for my nhs ivf qualification. I was desperate. I agree diabetes not fully responsible with pcos and underactive thyroid. (Thyroid problem due to starving myself, on numerous occasions.)
I've had diabetes in remission, a few times.

AndBreathe said:

but we really do need to be helping people find realistic hope and expectations.

Click to expand...

I agree wholeheartedly. This website and forum do a really good job in giving that message, and we should all try to reinforce the positive message.

Wasting valuable time discussing the minutiae of how we interpret the meaning of words can only cloud the messages we should be giving.

Hi @britishpub, the thread seems to have gone off tangent .
I achieved good results reduced carbing and 30 minutes a day activity, lost 2 stone , so I know that works for me . I went off the rails abit recently then I hurt my knee so can't be active at the moment . My FBS went up to 7.2 so I am now doing the 800 calorie thing and my FBS is 5.2. So do I think my diabetes was reversed, NO . Do I think it can go in remission or indeed controlled YES.



My type 2 diabetes is genetic , father and paternal grandmother both type 2.

EdMac said:

The distinction between diabetic, diabetic in remission and reversal is not, for me, the minutiae - there is nothing trivial about the difference between a life of choice and a life of greatly diminished choice.

I understand that some people feel more comfortable adopting an identity level label "I am a diabetic" and shielding themselves from choices they may feel will be their undoing. And I have no personal issue with that as a strategy - although adopting any cause effect pattern as a personal mantra is itself extremely limiting and potentially problematic.

So for those reasons I don't think shielding newly diagnosed diabetics from the potential to reverse their diabetes is a better option than alerting them, albeit with sensible expectation managing framing, to the full scope of potential positive outcomes. I for one wish I had known in 2012 that there was a diet I could have tried to nip things in the bud - even though it came with no guarantee of success.

Click to expand...

I'm sorry but I haven't got a clue what you are trying to say here

Well...
Am I in remission or reversed or cured - lets throw the C word in there as well.

The answer is yes to them all.

I am in remission of the symptoms. I have reversed the effects food/stress/exercise has on my BG levels. Therefore I have cured myself.

However, the symptoms could come back by reversal of my reversal by me "catching" the disease again. How that happens will not be through the same mechanism as last time although do any of us really know the root cause. I certainly do not and the more I find out the more I question.

By the way I can eat high carb meals and regularly do for extended periods of time (4 months up to my last HbA1c) and my BG levels are actually always better when I do instead of when I'm low carbing. However, fasting for more than 18 hours is when my body loves to really sort out its BG levels to a nice flat line of 4.8 mmol/l constant.

Andrew Colvin said:

Well...
Am I in remission or reversed or cured - lets throw the C word in there as well.

The answer is yes to them all.

I am in remission of the symptoms. I have reversed the effects food/stress/exercise has on my BG levels. Therefore I have cured myself.

However, the symptoms could come back by reversal of my reversal by me "catching" the disease again. How that happens will not be through the same mechanism as last time although do any of us really know the root cause. I certainly do not and the more I find out the more I question.

By the way I can eat high carb meals and regularly do for extended periods of time (4 months up to my last HbA1c) and my BG levels are actually always better when I do instead of when I'm low carbing. However, fasting for more than 18 hours is when my body loves to really sort out its BG levels to a nice flat line of 4.8 mmol/l constant.

Click to expand...

Wow, congratulations! Interesting that you mention that your glucose levels are better when you regularly eat carbohydrates compared to when lowcarbing, that is definitely food for thought for many here. May your current state last for many years

britishpub said:

None, but they would all be wrong.

I would know, which is all that would matter.

Click to expand...

And for you there is nothing wrong with that. But if those 50 reports all showed 60 plus and the 50 quacks all said you had diabetes would they all be wrong? My point is right or wrong the HbA1c is the accepted measurement of Diabetes and surely it is the only guide to whether or not you have diabetes

britishpub said:

I agree wholeheartedly. This website and forum do a really good job in giving that message, and we should all try to reinforce the positive message.

Wasting valuable time discussing the minutiae of how we interpret the meaning of words can only cloud the messages we should be giving.

Click to expand...

Here I disagree. The minutiae of whether you have diabetes or not can effect your everyday life from Driving Licences to Insurance costs and even employment opportunities. This can be affected by a doctors decision that you are "Cured"
That doesn't change how you look after yourself and the lifestyle you choose to follow ie: Diet, Testing etc

The above is very true. A cure is a cure but how permanent are most cures? A diabetic in remission is little different to an alcoholic who hasn't had a drink, I suppose.

muzza3 said:

Here I disagree. The minutiae of whether you have diabetes or not can effect your everyday life from Driving Licences to Insurance costs and even employment opportunities. This can be affected by a doctors decision that you are "Cured"
That doesn't change how you look after yourself and the lifestyle you choose to follow ie: Diet, Testing etc

Click to expand...

I'm not sure if you are deliberately misunderstanding, or are you unable to follow an argument ?

The minutiae I was very clearly talking about was whether or not we should waste time discussing what these words mean, not whether or not you can be cured of Diabetes or be classed as not having Diabetes by the medical profession.

I have never said, nor do I think that somebody cannot reverse, be cured of, or have their Diabetes enter remission.

How you, or anybody else views their current status is irrelevant to me.

I view my current status as having excellent control over the Diabetes that I still suffer from. It is certainly not cured, nor reversed but probably could be considered in remission.

For your information the DVLA will not penalise me for being a T2D that is not controlled by medication, it will in no way affect my employment and so far has not made any difference to any Insurance product I either held prior to, or have bought since diagnosis.

I doubt it. I was clearly saying that wasting time discussing what these words mean is potentially confusing, and unhelpful when we should be concentrating on helping people and offering support.

britishpub said:

I'm not sure if you are deliberately misunderstanding, or are you unable to follow an argument ?

The minutiae I was very clearly talking about was whether or not we should waste time discussing what these words mean, not whether or not you can be cured of Diabetes or be classed as not having Diabetes by the medical profession.

I have never said, nor do I think that somebody cannot reverse, be cured of, or have their Diabetes enter remission.

How you, or anybody else views their current status is irrelevant to me.

I view my current status as having excellent control over the Diabetes that I still suffer from. It is certainly not cured, nor reversed but probably could be considered in remission.

For your information the DVLA will not penalise me for being a T2D that is not controlled by medication, it will in no way affect my employment and so far has not made any difference to any Insurance product I either held prior to, or have bought since diagnosis.

Click to expand...

How about additional life insurance? You even get a free pen just for applying and a welcome gift when you've paid your first payment....don't forget.

DaveNN said:

The above is very true. A cure is a cure but how permanent are most cures? A diabetic in remission is little different to an alcoholic who hasn't had a drink, I suppose.

Click to expand...

Ironically myself and my partner said the same thing this afternoon.
What deems a recovered alcoholic no longer an alcoholic?
We came to the conclusion the will to drink would have to be no longer a driving force for the addiction.
So we also concluded the body would have to not cause high sugar levels when eating like a non-diabetic?