Reversing Type2

geoffwootten said:

There is a lot of talk about reversing type2 but no mention of those of us that are on insulin.
I was diagnosed 18 years ago but after taking metformin for about 6 weeks,with all the sickness and diarrhoea problems,my blood levels went so high the readings were off the scale.
Have been on vovomix 30 now for 9 years and test 4/6 times a day to help avoid hypos.
Does anyone think this is reversible?
BMI 25

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I wouldn't have a clue, and really nor would anyone else really.

What I would say is we have evidenced a number of T2s, who were initially taking insulin, reduce then stop insulin when they made some changes to their eating and/or other lifestyle aspects. So much depends on whether your own body is able to recover and cope without insulin, if your diet is adding to the mix.

Clearly, I would not consider telling anyone how to manage their insulin, so you could need support with that, unless you are confident with adjusting doses yourself. Most people find reducing the amount of carbs they eat has a two-fold impact. Firstly, those with a pancreas functioning at a reasonable level find their blood sugars reduce, which for those on insulin can mean they need reduced doses, and secondly, many lose weight. Not everyone, but many.

To extrapolate that as far as reversal would be very bold at this stage, but I guess where I am coming from is why not set yourself some credible targets - to reduce your blood sugars or safely reduce your insulin doses (with appropriate support), with a sideline of maybe trimming up a bit, if you get double lucky?

Should you manage to see some improvements, in whatever you decide is most important to you, then you can begin to plan what any next stage might be and what a longer term approach could look like.

Were you unfortunate enough to have a pancreas that really is just too tired and worn out to bounce back, you may still be able to improve things, if your diet could be tweaked at all, but starting with an all or nothing approach to reversal could be a tricky one.

In Professor Taylor's work, of his initial subjects 40% achieved "reversal" by the end of their 8 week programme and one more, making 43% had achieved the same markers by the end of a six month time frame.

There is no doubt 43% in six months is extremely laudable, but it clearly isn't guaranteed for anyone, so please consider setting yourself up for a resounding success (improvement), rather than risking joining a devastated 57% likelihood.

I do hope that doesn't come across as a downer, because that absolutely isn't what I want to express, but sadly we often see folks embark with a full expectation they will reach the holy grail, only to find they don't, then we rarely encounter them again. I often wonder if they continue with their improved results or revert to where the started. I'll never know.

Good luck with whatever you choose to do, but if you do decide to "Do something", please ensure you are managing your insulin safely.

I was diagnosed 22 years ago and I have been on insulin about 20 years and I have asked that question but no one knows the answer to this as I have been on tablets and just insulin by itself and I am now on humilin M3 I have been on metformin and other tablets that they use for diabetes and I have also been on victoza which is used to control your weight loss which helped me to lose a lot of weight and I am fine with that just takes a while to get used to being the weight I am now and I am happy about it

geoffwootten said:

There is a lot of talk about reversing type2 but no mention of those of us that are on insulin.
I was diagnosed 18 years ago but after taking metformin for about 6 weeks,with all the sickness and diarrhoea problems,my blood levels went so high the readings were off the scale.
Have been on Novomix 30 now for 9 years and test 4/6 times a day to help avoid hypos.
Does anyone think this is reversible?
BMI 25

Click to expand...

Hi @geoffwootten ,

Firstly I think you need to be wary about the term reversible. My understanding is that once you are diagnosed as a diabetic you're always going to be a diabetic even if you find a way to manage it without medication, which is basically what people are saying.

I was also told by my endocrinologist that once a person starts insulin treatment, then they're highly unlikely to ever come off it. That said, there is at least one T1 on the forum who is managing her honeymoon period effectively with diet control and has stopped using insulin (at least in the short term.)

So I guess I'm not saying it's impossible for you because it may depend strongly on the details of your own circumstances, and frankly I don't actually know. So I'll be interested in responses from other T2's on this.

Are you already doing anythiing else such as low carbing?

geoffwootten said:

There is a lot of talk about reversing type2 but no mention of those of us that are on insulin.
I was diagnosed 18 years ago but after taking metformin for about 6 weeks,with all the sickness and diarrhoea problems,my blood levels went so high the readings were off the scale.
Have been on Novomix 30 now for 9 years and test 4/6 times a day to help avoid hypos.
Does anyone think this is reversible?
BMI 25

Click to expand...

Geoff - You could start a thread asking for other T2s who have reduced and come off insulin to give you feedback on their experiences? I think @13lizanne was someone who used to be on insulin, but I could be very wrong! Apologies for the shout out if my memory serves me badly Lizanne.

geoffwootten said:

Thanks for that it really confirmed what I thought.Have not had any bread for months now and hardly any potatoes ,can if a bit low.
HBA1C in December was 7.2 in old money and now down to 6.2,my guess going by average if meter readings,also with less insulin.So lower carbs does appear to be working.

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Sounds good. As suggested by @AndBreathe above, you might reach a point where you can reduce your insulin - don't lose hope just yet!

geoffwootten said:

Thanks for that it really confirmed what I thought.Have not had any bread for months now and hardly any potatoes ,can if a bit low.
HBA1C in December was 7.2 in old money and now down to 6.2,my guess going by average if meter readings,also with less insulin.So lower carbs does appear to be working.

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As an avid reader, I also note many T1s who embrace trimming their carbs back note that as well as seeing lower blood scores, some have fewer hypos, because they need to inject less insulin. Less insulin = less room for over-injecting because of a slight carb-counting error.

I don't want to go all evangelical on it, but it really has shown decent results for so many people, and after a while potatoes just seem like a waste of plate space, in my world at least.

Good luck with it all.

AndBreathe said:

Geoff - You could start a thread asking for other T2s who have reduced and come off insulin to give you feedback on their experiences? I think @13lizanne was someone who used to be on insulin, but I could be very wrong! Apologies for the shout out if my memory serves me badly Lizanne.

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I have never been on Insulin I was on same dose of Metformin for 9 yrs then Gliclazide 40mg for a few weeks

13lizanne said:

I have never been on Insulin I was on same dose of Metformin for 9 yrs then Gliclazide 40mg for a few weeks

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Sorry. Sorry! My memory is usually pretty good, but not this time!

Not to worry, it's a common complaint

Jason Fung (of T2 fasting fame) mentions massive medication reduction and removal (including stopping insulin). He has his own website, a blog, and i have seen a number of well referenced lectures available on you tube, if you wanted to hunt them out.

My main concern would be whether a 'T2' who rapidly escalated to insulin after diagnosis was actually T1. It isn't always child onset. You may already know the answer to that.

If that were the case, fasting would be more complex and would need full professional support. Dieting and low carbing are all perfectly doable, but insulin would always be needed. There are so many insulin regimes and brands, there must be a suitable option somewhere, it is just a question of finding it - but that is going to depend hugely on the quality of advice you get. Do you attend a diabetes clinic for monitoring, or your local surgery for everything?

@geoffwootten I believe @AndBreathe is correct in saying that there are some type 2s who may have come off of insulin. I too have read this mentioned in posts on this forum but unfortunately also cannot recall which threads. Why don't you go onto Success Stories & Testimonials forum and type "coming off insulin" into the search box? Just a thought.

urbanracer said:

Hi @geoffwootten ,

Firstly I think you need to be wary about the term reversible. My understanding is that once you are diagnosed as a diabetic you're always going to be a diabetic even if you find a way to manage it without medication, which is basically what people are saying.

I was also told by my endocrinologist that once a person starts insulin treatment, then they're highly unlikely to ever come off it. That said, there is at least one T1 on the forum who is managing her honeymoon period effectively with diet control and has stopped using insulin (at least in the short term.)

So I guess I'm not saying it's impossible for you because it may depend strongly on the details of your own circumstances, and frankly I don't actually know. So I'll be interested in responses from other T2's on this.

Are you already doing anythiing else such as low carbing?

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Actually, some of the current claims are to at least remission (a better outcome than management), if not cure.

Those in the Newcastle study returned to normal eating, albeit at a level which maintained the weight at which they went into remission. But they were not carb restricted - all they have to do to stay in remission is to eat a balanced diet in quantities that sustains (rather than grows) their weight. This remission has lasted at least 11 years in one patient who is not managing it beyond maintaining a normal weight.

I'm not certain about those claiming to be in remission following Dr. Fung's fasting protocol. He has chosen to keep the details proprietary (i.e. he charges a hefty fee, with a wait list of longer than a year to start, and has chosen not to do a peer-reviewed study so there is no solid information about either protocol, or post-remission care. He does some form of intermittent fasting to put the disease into remission - but it is not clear whether they eat normally after that.

The Newcastle study group, at least, contrasts to LCHF - which is disease management without medication. My disease is managed at the moment. Unlike the Newcastle participants (and possibly unlike the intermittent fasting cures), if I stop the intensive management, my blood glucose is instantly back to where it was before.

As far as insulin, both individuals claiming cures have patients at least in remission who started on very high doses of insulin.

Firstly, I think it depends on why you're on insulin in the first place... are you on it to get good BGL control? or are you on it because you have insulin deficiency? For me it's the latter and I've been told I can't come off insulin because I hardly produce any of my own. So I guess if I don't take insulin I will be living with high sugar levels no matter what I eat.

As for 'reversible' I wouldn't consider that a correct term for diabetes under control. I would think to prove you've reversed diabetes then you should be able to eat whatever you want and have absolutely no effects on your sugar level which should stay in normal range. I dare say most people who claim it's reversed are really saying they eat well and have control of their diabetes. I was also told there is no cure for diabetes... but there is such a thing as good control.

This case study may be provide some hope for those who have been on insulin for many years...
http://www.dietdoctor.com/diabetes-reversed-after-26-years-of-insulin-dependence

"My story nearly matches Bernard’s! I was taking 170 units of Lantus a day and a handful of metformin along with meds for coronary artery disease, and a host of other illnesses. I was diabetic for 26 years, this poor old body has Crohn’s disease, Barrett’s esophagus, hypertension, hypothyroidism, esophageal spasm, gastro paresis, both types of arthritis and more… blah, blah, blah… I was taking close to $1200.00 a month in medications. I believe mainly based on inflammatory/autoimmune disease."

Whatever your definition of remission may be, being able to reduce that amount of medication is astounding!

kokhongw said:

This case study may be provide some hope for those who have been on insulin for many years...
http://www.dietdoctor.com/diabetes-reversed-after-26-years-of-insulin-dependence

"My story nearly matches Bernard’s! I was taking 170 units of Lantus a day and a handful of metformin along with meds for coronary artery disease, and a host of other illnesses. I was diabetic for 26 years, this poor old body has Crohn’s disease, Barrett’s esophagus, hypertension, hypothyroidism, esophageal spasm, gastro paresis, both types of arthritis and more… blah, blah, blah… I was taking close to $1200.00 a month in medications. I believe mainly based on inflammatory/autoimmune disease."

Whatever your definition of remission may be, being able to reduce that amount of medication is astounding!

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Great... I take it she had her own insulin being produced? (it doesn't say) This type of diet is based on the old starve a diabetic model.... one meal a day and fast for 3 days. I'd think this type of diet would put those of us with hardly any or no insulin in trouble. No food = ketones, low insulin = ketones... leads to DKA... dangerous.

This sort of thing could probably be adopted by people who do not have insulin deficiency but perhaps insulin resistance only.

Mep said:

No food = ketones, low insulin = ketones... leads to DKA... dangerous

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For T2D...DKA is rare. Having ketones doesn't automatically leads to DKA. It is high level of ketones that leads to DKA.

Personally I didn't do much fasting myself...I started with carbs reduction only. I only tried occassional intermittent fasting, 2 meals a day, skip dinner, 2 days a week when my fasting glucose remains high, around 7mmol. After IF for a couple of weeks, it remains stable around 5.5-6.0 mmol. I seldom fast after that.

My take is that there is really no hurry in this so long as we are going in the right direction with carbs reduction. Because some of us may need more time to adjust to the new lower glucose level.

kokhongw said:

For T2D...DKA is rare. Having ketones doesn't automatically leads to DKA. It is high level of ketones that leads to DKA.

Personally I didn't do much fasting myself...I started with carbs reduction only. I only tried occassional intermittent fasting, 2 meals a day, skip dinner, 2 days a week when my fasting glucose remains high, around 7mmol. After IF for a couple of weeks, it remains stable around 5.5-6.0 mmol. I seldom fast after that.

My take is that there is really no hurry in this so long as we are going in the right direction with carbs reduction. Because some of us may need more time to adjust to the new lower glucose level.

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Yes, so my guess is you still produce your own insulin.

There is no way a person who hardly has any insulin or no insulin could get away with skipping meals, etc without some consequences. I already had this happen to me recently when I went to ER. I was told I must eat. The reason was because they found ketones and also because I was sick. If I carried on that way I would wind up with DKA. A person with their own insulin probably wouldn't unless severely sick.

So when giving this sort of recommendation about diet you need to be careful to consider that not all type 2's have sufficient insulin, rather than approach it from the view that type 2's are all the same. There's quite a few of us that are on full time insulin therapy because of lack of insulin. I would also suggest that type 2's should know the state of their insulin production first by getting the diagnostic tests done again before attempting diets of this nature.... that means discussing with your doc. I've had the GAD and c-peptide done 3 times so far and the latest test showed I hardly produce any insulin.