Maybe the most common question I get from patients is “how can I get rid of my diabetes?” Well, in spite of what you may see in ads for supplements or in promises of fad diets the answer is almost certainly “NO.” But, so what? The real question is can you manage diabetes to preserve your long term health? That answer is YES!
Can I Get Rid of My Diabetes?
Hi everyone….Toby Smithson at Diabetes Every Day. I get a lot of my material from questions my “patients ask me, and this is one of the common ones – can I get rid of my diabetes or can I reverse diabetes or can diabetes be cured? These are all basically the same question, and the answer is no……….but. And that’s kind of a big “but” for type 2.
Ok…quick review. When we eat carbohydrates…and “we” is everybody….our digestion frees glucose which is released into our bloodstream raising “blood glucose” or blood sugar levels above the ideal level of between 70 and 99 mg per deciliter of blood.
As blood sugar begins rising the natural process is that our pancreas releases insulin and the insulin rounds up the excess glucose and stimulates cells…primarily muscle and liver cells….to store this excess glucose until it’s needed for energy. Stashing glucose in cells lowers the amount in our blood back to an ideal level.
Type 1 Diabetes – Can I get rid of it?
Ok…in type 1 diabetes the pancreas cannot produce the insulin necessary to get cells to take in glucose, so blood sugar levels go up….and up….and up. Type 1 diabetes requires insulin from an external source…typically this would be an injection or an infusion with an insulin pump.
Several strategies to cure type 1 have been tried with some success, including pancreas transplantation or the transplantation of the islet cells which produce insulin, and other ideas hold promise.
But it would be misleading to say that a cure is available.
Type 2 Diabetes – Can I get rid of it?
Type 2 diabetes is a little less straightforward. In the early stages of type 2 diabetes, or in what’s called prediabetes, there is no shortage of insulin. But the cells that normally respond to insulin by allowing glucose to come into the cell for storage are not being so cooperative.
The cells are becoming resistant to insulin, and blood sugar levels remain higher than normal even as the pancreas cranks out more and more insulin. Over time the pancreas poops out and insulin levels drop. That’s why type 2 diabetes is considered a progressive condition, and why people with type 2 tend to switch medications to address the changes over time.
Fasting Blood Glucose Levels
OK….the standards say that fasting blood glucose levels from 70 to 99 are normal, from 100 to 125 are prediabetes, and higher than 125 after fasting or any blood sugar reading of 200 or higher is “diagnostic” for type 2 diabetes. Now…these numbers are not scientific absolutes, like the speed of light.
For instance, the Diabetes Prevention Program beginning in 1996 showed that people with prediabetes reduced their risk for progressing to a diabetes diagnosis by 60 to 70 percent by changing their lifestyle habits, losing a modest amount of weight, and getting educational and goal setting support.
A follow-up study showed this success held for 15 years…they stopped the typical “prediabetes to type 2 diabetes” progression. So, would it be correct to say “that’s all good for prediabetes, but if you ever meet the definition for a diagnosis of type 2 diabetes….like a fasting blood glucose of 132 instead of 122 for prediabetes…. then everything changes”? Of course not. These lifestyle changes can make a huge difference wherever you find yourself.
The Bottom Line
But the question of getting rid of diabetes or reversing it or curing it is misplaced. Can you get your fasting blood glucose levels down to a target range for people without diabetes? Maybe, maybe not.
Can you get your A1C below 6.5%? Maybe, maybe not. Can you keep them there for 15 years? Maybe, maybe not.
Can you do it without medication? Maybe, maybe not.
Are you then cured or reversed if you do? What difference does it make? It’s not a contest…you are managing diabetes effectively.
And you can manage diabetes effectively if you need medication, or if you don’t see blood sugar levels in the target range.
Focus on lifestyle, focus on averages, focus on time. The goal is a long and active life managing diabetes, not fretting over what to call it. Thanks for watching, cheers to your health.
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