Can Diabetes be reversed ? The truth about Diabetes remission (not Reversal)

Created on : #jan2025

If you find this useful, please use the link to see the various ways in which you can Support us →
For online consultation with Dr. Om J Lakhani please use the following link Online Consultation →
Corresponding notes for doctors : Diabetes Remission

Diabetes Remission vs. Reversal: Why "Remission" is the Preferred Term

The use of "diabetes remission" instead of "diabetes reversal" is a deliberate choice based on a nuanced understanding of type 2 diabetes and its management. Here’s why:

Q. Why is "remission" used instead of "reversal" for type 2 diabetes?

Remission suggests a temporary state where diabetes is well-managed, but it can return.
Reversal implies a permanent change, which can be misleading.
Type 2 diabetes is a chronic condition that can relapse if triggering factors resurface.

Q. Does diabetes remission mean a patient is cured?

No, remission is not a cure.
Patients achieving remission still require ongoing monitoring and lifestyle adjustments.
Some metabolic and genetic predispositions remain even when blood sugar normalizes.

Q. What is the medical consensus on this terminology?

Leading organizations like the American Diabetes Association (ADA), European Association for the Study of Diabetes (EASD), and Diabetes UK agree that "remission" is the most appropriate term.
The consensus provides consistent language for healthcare professionals and research.

Q. What happens if people believe in "reversal" instead of "remission"?

It may mislead patients into thinking diabetes is permanently gone.
This can lead to neglect of follow-ups and lifestyle maintenance, increasing the risk of relapse.

Q. Does diabetes remission require ongoing care?

Yes, even in remission, diabetes requires monitoring.
Blood glucose should be checked regularly.
Healthy lifestyle habits must be maintained to prevent recurrence.

Q. How does diabetes remission compare to remission in other diseases?

Similar to oncology, where "remission" is used when cancer is undetectable but may return.
It reflects that underlying risks still exist despite normal clinical markers.

Who Can Achieve Remission?

Type 2 Diabetes: People with type 2 diabetes, especially those who are younger, overweight, or have fatty liver or pancreas, are good candidates.
Other Types: Some types of diabetes caused by medications, pregnancy, or other conditions can also go into remission.
Not Possible: Type 1 diabetes and certain genetic forms of diabetes (like MODY) cannot achieve remission.

How is Remission Defined?

HbA1c: Your average blood sugar level (HbA1c) should be less than 6.5% for at least 3 months.
No Medications: You should not be taking any diabetes medications during this time.
Ongoing Monitoring: You still need regular check-ups to make sure your diabetes stays under control.

How Can You Achieve Remission?

Weight Loss: Losing weight is key. This can be done through:
- Healthy eating and exercise.
- Meal replacement programs.
- Medications that help with weight loss.
- Bariatric surgery (weight loss surgery).
Early Intensive Insulin Therapy: In some cases, short-term insulin treatment can help improve your body’s ability to manage blood sugar.

What Are the Benefits of Remission?

Improved Health: Better blood sugar control can reduce the risk of complications like heart disease, kidney problems, and nerve damage.
Quality of Life: You may feel better and have more energy.
Cost Savings: You might save money on medications and healthcare.

What Are the Challenges?

Maintenance: Remission requires ongoing effort. You need to stick to a healthy lifestyle.
Relapse: If you regain weight or stop following healthy habits, diabetes can return.
False Promises: Be cautious of quick fixes or products that claim to cure diabetes. There’s no magic solution.

What Do Studies Say?

DiRECT Trial: A study showed that 46% of people who followed a weight loss program achieved remission after 1 year, and 36% maintained it after 2 years.
Bariatric Surgery: Weight loss surgery has helped many people achieve remission, with 76.6% staying medication-free for 2 years.
Early Insulin Therapy: Short-term insulin treatment has helped some people achieve remission, especially if they had diabetes for a short time.

Key Takeaways

Remission is Possible: With the right approach, many people with type 2 diabetes can achieve remission.
Lifestyle is Key: Weight loss and healthy habits are crucial.
Ongoing Care: Regular check-ups and monitoring are essential to maintain remission.

If you think you might be a candidate for diabetes remission, talk to your doctor about the best approach for you. Remember, remission is a journey, not a one-time event. Stay committed to your health!