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Type 2 Should I Classify Myself as ‘In Remission’?

Rachox

Rachox

Oracle
Retired Moderator
Messages
18,392
Location
Oxford
Type of diabetes
I reversed my Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
I have logged into my profile several times to change my diabetic classification, and hovered over the Type 2 (in remission) button. There is also a ‘Reversed’ option too. I don’t really like either term as I just consider myself very well controlled with my last three HbA1cs in the mid 30s. I feel I deserve one of the alternative classifications (sorry, blowing my own trumpet:oops:) and I think I prefer ‘In Remission’. Shall I change it or shan’t I? What do you all think?
 
Change it, @Rachox. You certainly deserve 'out there' recognition for all your hard work, and it also encourages others when they see in remission/reversed - it does for me. Blow away! :)
 
I think those words mean the same thing, really. imo. So it is completely up to you. Do you have a particular preference?
 
I also hesitated for a long time about changing my description - there are some arguments over what a 'normal' diabetic should be classed as, but after over 6 months I thought I should admit to the undeniable fact that something had changed.
 
Rachox said:
Shall I change it or shan’t I?
Click to expand...

I had mine showing "In remission" and also dared to show in my status that my GP had decided to tell me my Diabetes was "resolved", but I was lambasted about it after posting an opinion on one of those threads about what would constitute a reversal, so I changed them back to just being a normal T2D.

People will always pick arguments with you, and try to tell you how you can or can't describe yourself, so I would leave it as it is.

You know, and that is all that matters.
 
Well my GP has changed all my computer records, without even discussing it with me, to show my diabetes is resolved and back dated it to when I first went under 48 (June 2014), and has moved my original diagnosis from "current problems" to "past problems". Noticed it on my on-line records and spoke to him over the phone. He said as the WHO stipulates under 48 to be normal, and as I have remained under 48 for nearly 4 years without meds, he considers I am resolved. Full stop. My lowest HbA1c was 41. It is currently 43. I don't agree with him.

@Rachox you change your status to whichever one you prefer - although are you still on Metformin? Does that make a difference to "official" classification.? It did in Prof Taylor's definition, but didn't in the Virta Health one.
 
@Rachox your friends on here know. I'm guessing your sick of repeating the same advice?
Why don't you put reversal and sees how your treated by the community?
If I'm being honest if I got month on month none diabetic hba1cs I'd be shouting from the roof tops. ;)

My only advice is IF you experience a bad hba1c in the future what will you do?
Demote yourself and make yourself feel lousy?
I had unproven reversal. Maybe a few times in my life.
Ive had symptoms since as far back as i can recall. (6yr old definately).

Im currently struggling until after my op.
I won't be tagging myself as reversed when i get your results as my body didn't do it naturally.
I had to have intervention.

I don't recognise these reversals unless cured..... For myself. That's for only my self.

However im happy to rejoice in anyones hard hard work. If they want to tag themselves to a certain standard on here.
Maybe the newies will follow you more?
Which would be a good role model, in my eyes.

If you are considering it. I think you should.
Don't not do it incase of upsetting someone.... Ever!
A trophy. Im sending for such occasions..... Whilst you decide what to do, for you!

Im confident you will do the right thing! ;)
 
The phrase "in remission" make sense if someone has had treatment for cancer and doctors cannot be sure they've got rid of all of it. In their case it might resurface after 5 years.
But in the case of diabetes you'll be in a position to deal with any signs of a re-occurrence yourself.
It also sounds so negative.
You would never go to a garage to have your car fixed if they said it was just "in remission" after giving you the bill!
 
I have been wearing the 'reversed' badge for some time.
It is possible that the reversal could be reversed back the other way at any time. That keeps me motivated, because I will have to be honest and change the status here. I would have to work out what the label would then be. 'Pre-diabetes' doesn't seem right. So to avoid the dilemma I am doing my utmost to remain in reversed category.

@Rachox, if you are intending to be long term under the level to be labelled T2, and I am sure you are, I would say change your status here.
 
Just to add to my previous post. Surely the purpose of this forum is to get every avatar to say reversed. For type 2 this may be in the next 10 years and the next 50 years for type 1.
I would think the smallpox forums don't have many members!
 
I would say between the choices 'remission' and 'resolved' my preference is "in remission", because it is a chronic disease which has the potential to return under the 'right' conditions. My personal preference is "Type 2, diet controlled", or more correctly, diet controlled, facilitated by regular encouragement and support from my peers on this forum to sustain my control.

One very important question to consider in this debate: Does any of us really know what our personal beta cell reserve is like? Those of us who control this condition with a low carbohydrate diet are choosing to put very little stress on our pancreatic beta cells, so that those beta cells that we have left (and we are all individuals with different reserves - some may have more than others) will be able to cope with what we challenge them with, without resorting to medications or insulin.

So, whilst one of us may be in remission at 75gm carbohydrate/day, another may only achieve remission at 30gm/day or less for example. The common factor is we are both in remission through diet control/carbohydrate restriction/control and peer support, the variable is the amount of carbohydrate restriction needed to achieve - and sustain - our non-diabetic numbers.

The fact is, Type 2 DM raised its ugly head at least once under the right conditions/challenge and we know that it will raise its ugly head again under the same conditions again if they are permitted to return.
 
Despite 6 years of "normal" A1c levels, I only have to push the limit of 30+g of carbs in a meal, then measure my BG at 1 hour to know I'm not in remission or reversed. I guess it depends on what you define as "reversed" or "remission" as to how you define your current situation. I'm still Type 2 (even if well-controlled) and can't see that changing this late in the game.
 
Rachox said:
I have logged into my profile several times to change my diabetic classification, and hovered over the Type 2 (in remission) button. There is also a ‘Reversed’ option too. I don’t really like either term as I just consider myself very well controlled with my last three HbA1cs in the mid 30s. I feel I deserve one of the alternative classifications (sorry, blowing my own trumpet:oops:) and I think I prefer ‘In Remission’. Shall I change it or shan’t I? What do you all think?
Click to expand...
"Diabetes Superstar" should surely be the moniker for your good self..
 
Biggles2 said:
One very important question to consider in this debate: Does any of us really know what our personal beta cell reserve is like? Those of us who control this condition with a low carbohydrate diet are choosing to put very little stress on our pancreatic beta cells, so that those beta cells that we have left (and we are all individuals with different reserves - some may have more than others) will be able to cope with what we challenge them with, without resorting to medications or insulin.
Click to expand...
I believe doctors typically use an Oral Glucose Tolerance Test (OGTT) as a method which can help to diagnose instances of diabetes or insulin resistance.

In this test you take a fixed dose of glucose of about 70 grams (after fasting for 12 hours); then;

People without diabetes

Fasting value (before test): under 6 mmol/L

At 2 hours: under 7.8 mmol/L

People with impaired glucose tolerance (IGT)

Fasting value (before test): 6.0 to 7.0 mmol/L

At 2 hours: 7.9 to 11.0 mmol/L

Diabetic levels

Fasting value (before test): over 7.0 mmol/L

At 2 hours: over 11.0 mmol/L

I would say anyone achieving the non diabetic range after this test has reversed the diabetes whatever their adopted diet plan.
 
Those trying to define their diabetic state may be interested in this from the International Diabetes Remission Registry http://www.diabetesremission.org :

Definition of Diabetes Remission

Following international standards [1,2] a person goes into diabetes remission when the following conditions are fulfilled:

  1. Had a diagnosis of diabetes
  2. Fasting Serum Glucose (FSG) is less than 100 mg/ml (5.6mmol/l)
  3. HbA1c is less than 6.0% (42mmol/dL)
  4. There is no active hypoglycemic therapy (either pharmacological or surgical)


We define three levels of remission:

  • Initial. When the conditions are fulfilled for three months
  • Complete. When the conditions are fulfilled for one year
  • Operational cure. When the conditions are fulfilled for five years or more

James is at the "Complete" stage with "operational cure" coming up later this year. My own view is that he has reversed T2D, progression has stopped and there has been significant, indeed "amazing regression" ( words used by his opthalmology consultant). Of course he could make himself ill again by adopting a bad diet, but why would he want to do that?

Sally
 
Personally, in terms of the definition immediately above, I would include major dietary change in the hypoglyceamic therapy group
 
Boo1979 said:
Personally, in terms of the definition immediately above, I would include major dietary change in the hypoglyceamic therapy group
Click to expand...
Sorry, disagree. I don't think you can put stopping doing something damaging to your health in the same bracket as taking medications or having surgery. Many of us change our diet at various times in our lives (eg adopt or give up vegetarianism, learn to cook or live out of the local takeaway). Stopping doing something that is bad for you (and arguably for most people, diabetic or not) is simply a lifestyle choice.
Sally
 
sally and james said:
Those trying to define their diabetic state may be interested in this from the International Diabetes Remission Registry http://www.diabetesremission.org :

Definition of Diabetes Remission

Following international standards [1,2] a person goes into diabetes remission when the following conditions are fulfilled:

  1. Had a diagnosis of diabetes
  2. Fasting Serum Glucose (FSG) is less than 100 mg/ml (5.6mmol/l)
  3. HbA1c is less than 6.0% (42mmol/dL)
  4. There is no active hypoglycemic therapy (either pharmacological or surgical)


We define three levels of remission:

  • Initial. When the conditions are fulfilled for three months
  • Complete. When the conditions are fulfilled for one year
  • Operational cure. When the conditions are fulfilled for five years or more

James is at the "Complete" stage with "operational cure" coming up later this year. My own view is that he has reversed T2D, progression has stopped and there has been significant, indeed "amazing regression" ( words used by his opthalmology consultant). Of course he could make himself ill again by adopting a bad diet, but why would he want to do that?

Sally
Click to expand...

A bit confused here. In the quote above it refers to "no active hypoglcaemic therapy" etc. But in the references used to reach this definition it says "(anti-hyperglycemic medications, immunosuppressive medications) or surgical (ongoing procedures such as repeated replacements of endoluminal devices) therapy. So is the "active hypoglycaemic" a typo for "active hyperglycaemic"
 
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