Reverse Type 2 - a question

Naelm · Nov 24, 2016

Hi Everyone,

Energize's post is very interesting because I am three quarters of the way through a 16 week 800 calorie/day diet (Alevere). The interesting thing is that my fasting blood levels have gone down from 8.1 (with 2000mg per day) to 5.1mmol/l (with 1000mg metformin per day). I have lost 2.5 stone (17kg) and have another 1.5 stone to go (10 kg). Waist size is down from 44 to 34. My liver function appears to be back to normal (AL from 84 down to 24). I am now getting low sugar (hypo) blips in the middle of the night, but not sure if this is inaccuracy with Abbots Free Style Libre system or if the pancreas is now back to full insulin producing capacity acting with the metformin to reduce blood sugar.

So the question is how do I know if the diabetes is in remission. To be honest, I will settle for managing my diabetes through diet, but it would be nice to reverse this disease. But how will I recognise it. My HBA1c has always been below 40 after I was first diagnosed 2 years ago so it does not seem to throw a great deal of light on the state of diabetes. Sooner or later, I will stop the metformin and try a few days without metformin to see what happens, but how will I know if it is ok without the metformin?

Any ideas anyone? If anyone has successfully completed this diabetic reversal diet, I would really love to hear your experiences.

Nael

Energize said:
Hi Sparrow

Well done for dropping your HbA1c and certainly it would seem you have good control. You don't say what medications or diet you are currently on. You mentioned that if you 'slip off diet or stop taking tablets' so that suggests to me that you are on some medication for your diabetes and also on a specific diet related to controlling your diabetes.

My interpretation of 'Reversed Type 2' would be when taking NO medication for diabetes, including Metformin, and able to eat a 'normal' diet, ie including some bread, potatoes, pasta, rice, pastry etc, without blood glucose levels raising more than a non-diabetics would. However, if any meds or diet is required to control blood glucose levels, to my mind, you would still be considered diabetic.

I think, but I could be wrong of course, that someone who has (probably lost a lot of weight) been able to come off all meds can then have a normal glucose tolerance test. For me, this is what I understand/feel is 'reversed' diabetes. The diabetes would 'return' if the diabetic gained sufficient weight to increase insulin resistance again and then have raised blood glucose levels.

I don't feel a diabetic can 'cure' their diabetes, even if glucose levels return to normal without meds/diet. I tend to think of it as being 'in remission', suggesting this state is potentially only temporary and could show itself again at some stage, or maybe not show itself ever again.

So, that's just my personal view. Hopefully, others will be able to correct me if I'm not correct in this view

Brunneria · Nov 24, 2016

@Naelm you raise very good points.

I mean, dropping bgs on an 800 cal diet is inevitable (I would hope), so none of your readings while on 800 cals are representative of anything more than that 800 cals reduces blood glucose.

For an HbA1c to be informative, you would have to wait 2-3 months after going back to your long term eating pattern, so see if that had made a difference - and if you have had great (below 40) control up until now, then you should be at 40 or below in future - I hope.

Looks like you would have to go high carb for a while to test your bg reactions, and maybe do a glucose tolerance test. But that is just poking the tiger, isn't it?

By the way, if you go off the Metformin, give yourself a month or so for the drug to leave your system, before thinking you are Met free. It takes weeks to build up, and then weeks to leave the system too.

Naelm · Nov 24, 2016

chalup said:
For some the idea of a personal fat threshold may be true but for others I think the metabolism is just too broken for it to be that easy. Some people need medications and some maybe for life. I don't like the idea that if someone cannot beat this thing just by getting and staying below a certain, probably quite low, weight or BMI that there is potential for self blame and guilt there. It may not be possible for everyone.

Hi Chalup.

Working from a statistical sample of 1 (me), it would be stupid and presumptuous to extrapolate to anyone else. For me, it is not a matter of of potential for self-blame and guilt if I do not have a personal fat threshold. Personally speaking, and only personally speaking, it is a matter of self-blame and guilt for me if I do not find out if I have a personal fat threshold. And if I do not have one, and my metabolism is broken beyond repair, then I have the slim comfort that at least I tried.

Hope this removes any implication that there is conditional approval of anyone based on their metabolism (or any other attribute, for that matter).

Kindest regards

Nael

kokhongw · Nov 24, 2016

It is easy for us to forget that what we have "reversed" is the unfortunate series of complications/misfortunes that is certain to beset us if we had continued with the evidenced based path. The EVIDENCE is that reversal by any definition is a rarity. And it remains elusive for millions of families out there...

http://www.diabetes.org/research-an...ss-to-research/type-2-diabetes-remission.html

What did the researchers find?
Over 7 years, 1.47 percent of the entire group had a partial remission, 0.14 percent had a complete remission, and 0.007 percent had a prolonged remission. Overall, 1.60 percent of the entire group (4.6 percent of those who had been diagnosed for less than 2 years) had some sort of remission. People who were older than 65 years of age, were African American, had been diagnosed for less than 2 years, had an A1C of less than 5.7 percent at the start of the study period, or were taking no diabetes medicines at the start of the study period were more likely to have a remission.

What were the limitations of the study?
The data in this study came from routine clinical practice rather than from a research setting. Therefore, A1C testing did not take place at uniform times for all of the patients.

What are the implications of the study?
Type 2 diabetes remission can occur in people who have not had weight loss surgery, but it is very, very rare. Applying the results of this study to the entire 25.6 million Americans with type 2 diabetes suggests that 384,000 people could have some type of remission in the next 7 years. However, only 1,800 people would have a remission lasting at least 5 years.

Articles from Diabetes Forecast®
- See more at: http://www.diabetes.org/research-an...tps://www.google.com.sg/#sthash.HWXcUpOf.dpuf

andcol · Nov 24, 2016

kokhongw said:
It is easy for us to forget that what we have "reversed" is the unfortunate series of complications/misfortunes that is certain to beset us if we had continued with the evidenced based path. The EVIDENCE is that reversal by any definition is a rarity. And it remains elusive for millions of families out there...

http://www.diabetes.org/research-an...ss-to-research/type-2-diabetes-remission.html

Seems to be a bit of a flawed study. The researches do not know why it occurs? Really? Also their definition of complete remission is a normal HbA1c - really! Not what I would call remission just control. So what they measured is how long people can keep the control up for.

Did I misread the study? May be as I am drugged up at the moment

MikeTurin · Nov 24, 2016

andcol said:
Did I misread the study? May be as I am drugged up at the moment

http://care.diabetesjournals.org/content/37/12/3188
I'vwe done a quick read of the original article. They defined remission as
In addition to a return to normal or near-normal blood glucose levels in the absence of glucose-lowering treatment, these individuals have been found to have biologic evidence of remission, including normalization of β-cell function and hepatic insulin sensitivity as defined in http://care.diabetesjournals.org/content/32/11/2133

kokhongw · Nov 24, 2016

andcol said:
Seems to be a bit of a flawed study. The researches do not know why it occurs? Really? Also their definition of complete remission is a normal HbA1c - really! Not what I would call remission just control. So what they measured is how long people can keep the control up for.

Did I misread the study? May be as I am drugged up at the moment

no you did not misread. Not only is the study flawed, but the whole ADA approach to diabetes is flawed. Especailly when compare to the HbA1c normalization we know is achievable when we follow a carbs lite fats friendly approach.

But the rather obvious point is that even at the elevated level..."remission" as they so generously defined it, is already unfortunately rare...But some of us may not realize how unique our achievement is...and many remain bothered by whether we can continue to eat carbs normally...

andcol · Nov 24, 2016

All I will say is that they are American's so they had the deck stacked against them as almost all food over there is stuffed with fructose. I expect they immediately refilled their liver with fat again as soon as they started eating the "normal" (or should that be abnormal) standard processed foods.

kokhongw · Nov 24, 2016

Or to put in another context...if T2D was a slow cancer. And its death rate is tied to HbA1c. Would we not consider that our diabetes have been reversed when we have achieved the level of HbA1c with the lowest possible rate of death? Would it really matter that we can no longer eat in a way that would raise our level of HbA1c and correspondingly the risk of early death again?

Reverse Type 2 - a question

Naelm

Newbie

Brunneria

Guru

Naelm

Newbie

kokhongw

Well-Known Member

andcol

Well-Known Member

MikeTurin

Well-Known Member

kokhongw

Well-Known Member

andcol

Well-Known Member

kokhongw

Well-Known Member

Reverse Type 2 - a question

Newbie

Guru

Newbie

Well-Known Member

Well-Known Member

Well-Known Member

Well-Known Member

Well-Known Member

Well-Known Member

Privacy & Transparency

Privacy & Transparency