Reversing T2

jennygee said:

Can anyone advise what HbA1 level would indicate a reversal of T2? My result this week was 35 - when diagnosed two and a half years ago it was 69.

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Your name states you are insulin dependent? is that still correct?

Congratulations on getting the number down

"Reversal " of T2 diabetes would be when one can eat high carb foods and the same reaction to them that a non diagnosed person would have , whilst taking no medication. One could also have well controlled diabetes, either through diet or drugs but neither of those would constitute reversal per se absent the same reactions as a non diabetic person to the same foods .

I personally have a different perspective on reversal.
Reversal is going backwards from where you were.

I think a cure or remission is more about being able to tolerate carbs without spikes. But there is no dictionary of terms I don't think. I personally think just being drug free and a better HBA1C means I have reversed my T2. But I am in search of much more than good control.

I think it depends on your GP. Mine says NO and my last HbA1c was 35. I asked if I got it down to under 30 and he said that might be dangerous to try so I'm diabetic but GP did say with excellent control. I've been between 33 and 35 for 2 years so really hoped he would agree with remission. Someone did say they got more money for a diabetic!

At my surgery they need 18 months of non-diabetic HbA1cs on no meds. (18 months in my case is 3 tests.) I was invited to come off the diabetic register and be put on the "at risk" register but that would have meant changing from 6 monthly blood tests to 12 monthly, and I wasn't prepared to do that, so I declined.

Bluetit1802 said:

At my surgery they need 18 months of non-diabetic HbA1cs on no meds. (18 months in my case is 3 tests.) I was invited to come off the diabetic register and be put on the "at risk" register but that would have meant changing from 6 monthly blood tests to 12 monthly, and I wasn't prepared to do that, so I declined.

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I don't think my GP has even noticed my HbA1c results.. certainly wasn't mentioned during our call today...hey ho..

They are not meant to take you off the diabetic register if you have clearly been diabetic in the past, as the additional health checks are still needed.

ringi said:

They are not meant to take you off the diabetic register if you have clearly been diabetic in the past, as the additional health checks are still needed.

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Where did you read that? Its rubbish. NICE has clear instructions on how to do this.
The additional health checks will continue - but annually rather than more frequently than that.
Foot checks and retinal eye screening continues as normal.

There are specific codes the GP must enter on the system, and one is for "in remission" and one is "resolved", with instructions as to which one to use.

bulkbiker said:

I don't think my GP has even noticed my HbA1c results.. certainly wasn't mentioned during our call today...hey ho..

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It was my nurse that nagged me. I have never seen a doctor in relation to diabetes.

"Partial remission is sub-diabetic hyperglycemia (A1C not diagnostic of diabetes [<6.5% / <48 mmol/mol], fasting glucose 100–125 mg/dl [5.6–6.9 mmol/l]) of at least 1 year's duration in the absence of active pharmacologic therapy or ongoing procedures.

Complete remission is a return to “normal” measures of glucose metabolism (A1C in the normal range [<6.0% / <42 mmol/mol], fasting glucose <100 mg/dl [5.6 mmol/l]) of at least 1 year's duration in the absence of active pharmacologic therapy or ongoing procedures."

From "How Do We Define Cure of Diabetes?": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768219/

My opinion is that "ongoing procedures" does not include a low carb diet, but others may disagree.

Bluetit1802 said:

Where did you read that? Its rubbish. NICE has clear instructions on how to do this.
The additional health checks will continue - but annually rather than more frequently than that.
Foot checks and retinal eye screening continues as normal.

There are specific codes the GP must enter on the system, and one is for "in remission" and one is "resolved", with instructions as to which one to use.

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"in remission" keeps you on the "diabetic register" and hence getting the screening etc and your GP getting the additional payments. I expect the nurse does not know the difference between the "diabetic register" and their own list of people they wish to keep a close eye on.

jennygee said:

Thanks Cherry for your reply.
My profile was showing me as insulin dependent, but this was a mistake and I think I have rectified accordingly. I appreciate that true reversal is as you state, so in fact I can claim to be well controlled on diet. I realise there is no cure, but I will endeavour to keep my numbers low for as long as possible!
Jenny

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The Jury is still out as to whether or not there is an actual " cure". what is clear is that one can definitely mitigate it very effectively through diet.

What is becoming reasonably clear is that its not that some unfortunate people "get" diabetes - its more that the entire human race is heading down this path as a result of the changes we have made to our diet. As result by reverting to the correct diet, we are effectively making ourselves much healthier than we were, and in many cases a lot healthier than people who are un-diagnosed and still eating rubbish diets . As such it hardly matters with its a cure or a reversal because who would want to go back the eating the stuff that brought it ( and many other diseases) on in the first place ! What is superb is just how effective changing one's diet is to nursing us all back to health ! Its just a pity that so few know as yet . good luck !