What Constitutes 'Remission'

Mal37 · May 25, 2018

I see many posts where in the write up the person will say they are in remission.
Yes ... I do know what that means ... but how do you know when you ARE in remission?

Is it by a certain number that you get regularly when doing a fasting blood test or is it something else?

I would really like to know, and to have an idea what figures I should be aiming for.

bamba · May 25, 2018

According to DUK its acheiving sustained non-diabetic HbA1c without medication.
According to Prof. Taylor of Newcastle Diet fame - it's that, plus non-diabetic fasting blood glucose.

Mal37 · May 25, 2018

bamba said:
According to DUK its acheiving sustained non-diabetic HbA1c without medication.
According to Prof. Taylor of Newcastle Diet fame - it's that, plus non-diabetic fasting blood glucose.

So what numbers are they ... do you know?
I'm sorry to be so uneducated on this

Looseboy · May 25, 2018

Over what period of time would you think these are required to be maintained before a medical professional would agree with a remission diagnosis?

bamba · May 25, 2018

Mal37 said:
So what numbers are they ... do you know?
I'm sorry to be so uneducated on this

Blood sugar targets/diagnosis
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

HbA1c
https://www.diabetes.co.uk/what-is-hba1c.html

bamba · May 25, 2018

Looseboy said:
Over what period of time would you think these are required to be maintained before a medical professional would agree with a remission diagnosis?

That would depend on your review cycle and the medical professional in question.
With some of them it would be quick - with others it would depend on climate change in Hades.

pollensa · May 25, 2018

Mal37 said:
I see many posts where in the write up the person will say they are in remission.
Yes ... I do know what that means ... but how do you know when you ARE in remission?

Is it by a certain number that you get regularly when doing a fasting blood test or is it something else?

I would really like to know, and to have an idea what figures I should be aiming for.

Good valid questions.

Regards Remission some refer to reversal or partially reversed, there are quite a few guidelines, I mention in particular UK MD, Dr. David Cavans Book page relating to "can Diabetes be reversed" where he quotes shows guideline chart regards levels i.e. "defined in three stages remission partial, complete or prolonged, depending on duration and extent of return of normal glucose control without the need of diabetes medications, i.e. page 81 of the book, the three stages of diabetes reversal" as follows I quote....

fasting glucose mmol/l below 7 partial x 1 year. below 5.6 complete x 1 year. below 5.6 prolonged x 5 years
HbA1C mmol/mol below 48 6.5% partial x 1 year, below 42 6% and below 42 6% x 5 years

Regards what figures to aim for, thats is variable, perhaps ask your Doctor to present the cut off thresholds to aim for regards fasting, 2hr after eat, and random anytime after eat breakfast for a guide to aim for.

Hope this assists in someway.

Bluetit1802 · May 25, 2018

Mal37 said:
I see many posts where in the write up the person will say they are in remission.
Yes ... I do know what that means ... but how do you know when you ARE in remission?

Is it by a certain number that you get regularly when doing a fasting blood test or is it something else?

I would really like to know, and to have an idea what figures I should be aiming for.

Mal37 said:
So what numbers are they ... do you know?
I'm sorry to be so uneducated on this

There are no official guidelines on this. Generally speaking it is when you have an HbA1c of under 48 consistently for a period of time without medication. That period of time is not defined. It is entirely up to each doctor to decide as they have no guidelines or criteria to follow.

pollensa · May 25, 2018

bamba said:
Blood sugar targets/diagnosis
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

HbA1c
https://www.diabetes.co.uk/what-is-hba1c.html

A question if I may, did you notice on the blood sugar targets link the "fasting" levels have now changed from what used to be shown as 108mg/dl to now a lowered fasting cut off to 100mg/dl as now shown on the above link? Just thought I would share and raise to attention in case yourself or anyone out there may not have realized or noticed the lowering of fasting level, the other levels I notice are still showing the same as previous.

pollensa · May 25, 2018

pollensa said:
A question if I may, did you notice on the blood sugar targets link the "fasting" levels have now changed from what used to be shown as 108mg/dl to now a lowered fasting cut off to 100mg/dl as now shown on the above link? Just thought I would share and raise to attention in case yourself or anyone out there may not have realized or noticed the lowering of fasting level, the other levels I notice are still showing the same as previous.

Pleased shared info viewed informative, as the new levels result that those of us out there, making efforts, and aiming for 108mg/dl normal cut off reading previously, now, it means due to lowering of level indications, if their levels say are from 101, 102, up to say 107mg/dl this results one falls into a new category of Pre diabetes range overnight basically rather than normal range previously, rather concerning to say the least when all or any cut off changes take place.

Mbaker · May 25, 2018

I agree with @Bluetit1802 that it is down to your Doctor if you have an official position of remission, as it forms part of your documented medical record. I did not consider myself beginning remission until my HbA1c was 41 mmol or less, as above this is pre-diabetic; then there had to be several HbA1c's at this level or below, this is what I think.

Borrowing from other areas. "complete remission" in relation to cancer is 5 years of no evidence of disease - this is not cured however. A label is great as it can help with insurances, but it is more important to keep diabetes at bay.

Mr_Pot · May 25, 2018

Mbaker said:
I agree with @Bluetit1802 that it is down to your Doctor if you have an official position of remission, as it forms part of your documented medical record. I did not consider myself beginning remission until my HbA1c was 41 mmol or less, as above this is pre-diabetic; then there had to be several HbA1c's at this level or below, this is what I think.

Borrowing from other areas. "complete remission" in relation to cancer is 5 years of no evidence of disease - this is not cured however. A label is great as it can help with insurances, but it is more important to keep diabetes at bay.

Do doctors take into account that you are on a restricted diet when pronouncing you "in remission"? If I suffered from coeliac disease but hadn't had any problems for 5 years, due to avoiding any gluten, I don't think a doctor would say I was in remission. I don't want to re-visit the old controlled/remission/cured argument I just wondered if doctors regard a special diet as a form of medication.

bulkbiker · May 25, 2018

Mr_Pot said:
Do doctors take into account that you are on a restricted diet when pronouncing you "in remission"? If I suffered from coeliac disease but hadn't had any problems for 5 years, due to avoiding any gluten, I don't think a doctor would say I was in remission. I don't want to re-visit the old controlled/remission/cured argument I just wondered if doctors regard a special diet as a form of medication.

Then again you are making the assumption that gluten is part of a "normal" diet.. maybe for the past 8,000 years or so but the hundreds of thousands before that? I think we are in the process of forgetting what we ate for all the years before we became farmers and introduced seeds and grains into our diet mostly to the detriment of our health.

Mr_Pot · May 25, 2018

bulkbiker said:
Then again you are making the assumption that gluten is part of a "normal" diet.. maybe for the past 8,000 years or so but the hundreds of thousands before that? I think we are in the process of forgetting what we ate for all the years before we became farmers and introduced seeds and grains into our diet mostly to the detriment of our health.

I can't see what that has got to do with it. What I am asking is whether doctors take into account the fact that you are taking measures to avoid symptoms when considering whether your disease in remission. If I never go up any tall buildings, is my vertigo in remission?

bulkbiker · May 25, 2018

Mr_Pot said:
I can't see what that has got to do with it. What I am asking is whether doctors take into account the fact that you are taking measures to avoid symptoms when considering whether your disease in remission. If I never go up any tall buildings, is my vertigo in remission?

You said we are following a

Mr_Pot said:
restricted diet

I'm saying that we are eating what humans thrived on for hundreds of thousands of years. Gluten (and certainly not the processed gluten that we see today) was never part of that so coeliacs probably didn't exist before we become farmers.

lucylocket61 · May 25, 2018

bulkbiker said:
You said we are following a

I'm saying that we are eating what humans thrived on for hundreds of thousands of years. Gluten (and certainly not the processed gluten that we see today) was never part of that so coeliacs probably didn't exist before we become farmers.

You may not consider that your diet is restricted, as you seem to believe that your diet is going back to ones roots in an evolutionary sense? Have I understood that correctly?

If so that fine and good for your worldview. However, not everyone shares that view and therefore does, indeed, feel restricted in the modern sense of dietary understanding.

There is room for respect and acceptance all viewpoints on this one, I think.

bulkbiker · May 25, 2018

lucylocket61 said:
You may not consider that your diet is restricted, as you seem to believe that your diet is going back to ones roots in an evolutionary sense? Have I understood that correctly?

If so that fine and good for your worldview. However, not everyone shares that view and therefore does, indeed, feel restricted in the modern sense of dietary understanding.

There is room for respect and acceptance all viewpoints on this one, I think.

Possibly but when people come and say "oh you can't be in remission/reversed/cured because you cant eat a highly processed carb diet" I feel I have to say that eating that way is killing all of us, some slower than others maybe, but killing us all. I tend to reply with why would I go back to the way of eating that made me ill in the first place? But they rarely have an answer to that because that of course would be a completely stupid thing to do.
Our modern way of eating is simply not good for us.. eating proper food is not restrictive it's sensible. And yes I do get quite annoyed when people say otherwise especially people here who should know better. Rant over..

lucylocket61 · May 25, 2018

bulkbiker said:
when people come and say "oh you can't be in remission/reversed/cured because you cant eat a highly processed carb diet" I feel I have to say that eating that way is killing all of us, some slower than others maybe, but killing us all.

However, not all carbs are highly processed and refined. A for some of us, some carbs are beneficial to our health. I dont see how they can be said to be killing us all.

Mr_Pot · May 25, 2018

bulkbiker said:
Possibly but when people come and say "oh you can't be in remission/reversed/cured because you cant eat a highly processed carb diet" I feel I have to say that eating that way is killing all of us, some slower than others maybe, but killing us all. I tend to reply with why would I go back to the way of eating that made me ill in the first place? But they rarely have an answer to that because that of course would be a completely stupid thing to do.
Our modern way of eating is simply not good for us.. eating proper food is not restrictive it's sensible. And yes I do get quite annoyed when people say otherwise especially people here who should know better. Rant over..

This is not about what is a good or natural diet it is about doctors opinions. The OP asked when she could consider herself in remission. Replies suggested what medical professionals regard as remission. I asked whether doctors were influenced by what measures you were taking to control your symptoms. Perfectly correct and reasonable measures they are, but not standard NHS recommendation.

bulkbiker · May 25, 2018

Mr_Pot said:
This is not about what is a good or natural diet it is about doctors opinions. The OP asked when she could consider herself in remission. Replies suggested what medical professionals regard as remission. I asked whether doctors were influenced by what measures you were taking to control your symptoms. Perfectly correct and reasonable measures they are, but not standard NHS recommendation.

Except, and I am being a bit picky here, the OP did not ask about doctors that was introduced by other posters.
So I'm afraid I'm still of the view that 90% ? of doctors are so unaware of the benefits of diet that they wouldn't know "remission" when it smacked them in the face. To be honest I don't care what they think or how they choose to label me. I am a well controlled Type 2 which for me is what is important and I maintain this by eating proper food.

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