Is Remission Possible with Type 2 Diabetes? Short Answer: Yes
4 min. read
Baptist Health Miami Cardiac & Vascular Institute
You’ve heard of cancer going into remission. Could the same thing be possible with type 2 diabetes?
The short answer is yes. Although it may not be easy or achievable for everyone, remission seems to be more attainable than physicians initially believed.
“For someone who's really dedicated to beating diabetes, it’s absolutely achievable — more so now than in the past because we know more about diabetes and we have better ways of monitoring and treating it,” says preventive cardiologist Adedapo Iluyomade, M.D., of the cardiometabolic program at Baptist Health Miami Cardiac & Vascular Institute.
November is Diabetes Awareness Month, which aims to increase understanding and prevention of this increasingly common condition. About 11 percent of the U.S. population, more than 37 million people, have diabetes, according to the Centers for Disease Control and Prevention. Another 96 million people have prediabetes, and the numbers continue to rise at an alarming rate.
The relatively new concept of diabetes remission opens the possibility of managing the condition without medication or insulin injections.
What is Diabetes Remission?
“Diabetes remission is a newly coined term that refers to people who once had diabetes and no longer require medications because they have their condition under control,” Dr. Iluyomade explains.
In simple terms, remission is defined as having a blood-sugar level below the established threshold for a diabetes diagnosis, which is typically 6.5 on the A1C blood test, and maintaining it for at least three months while taking no medication.
Many strategies used to manage type 2 diabetes — including lifestyle changes, exercise, medication, weight loss and bariatric surgery — can help patients get to remission, according to joint guidelines from the Endocrine Society, the American Diabetes Association and other international groups. However, remission is most commonly associated with weight loss of 30 pounds or more.
A study published in The Lancet medical journal found that intensive weight management and low-carb eating led to remission in 46 percent of participants after one year. Follow-up research found that about 36 percent of participants remained in remission at the two-year mark. (Rapid weight loss is not advised if you are a healthy weight, are under 18, are pregnant, breastfeeding, or have ever been diagnosed with an eating disorder.)
How Does it Work?
To understand how losing weight can help someone go into remission, it helps to understand why excess weight can lead to type 2 diabetes.
Diabetes is caused by the body’s inability to create or effectively use its own insulin, a hormone produced by cells in the pancreas. Insulin regulates blood sugar levels by helping turn the energy in food we eat into fuel for our bodies. If not enough insulin is made, or the insulin produced cannot be used efficiently, sugar remains in the blood rather than being converted into fuel.
When carrying extra weight, especially in the belly area, fat can build up around important organs like the liver and pancreas. This makes it more difficult for them to work properly, contributing to Type 2 diabetes. (Other factors — like age, ethnicity and family history — also can influence how well the liver and pancreas work.)
Weight loss can cut fat levels inside the liver and pancreas, helping those organs function normally and better regulating blood sugar. Through lifestyle changes, dietary changes and weight loss, many people can make their bodies more responsive to insulin. “You correct the metabolic abnormality,” Dr. Iluyomade explains.
Factors to Consider
Diabetes remission should not be considered a cure, Dr. Iluyomade notes. Ongoing monitoring and maintenance are still necessary.
“The term remission is taken from the oncology world. When a cancer patient is in remission, they continue to undergo surveillance and remain very vigilant of their health, because they realize they are at risk of a recurrence as long as they live,” Dr. Iluyomade says. In the same way, using the word remission when it comes to diabetes reminds people that they could be at risk for developing it again, especially if their lifestyle and dietary habits change back.
“I really like the term,” he says. “I think it appropriately classifies that individual who has diabetes, but is victorious over it for all intents and purposes.”
Genetic predisposition, the amount of time since diabetes diagnosis and individual health conditions can influence the likelihood of achieving remission. However, the challenges should not deter people from pursuing it as a goal, along with a healthier lifestyle, Dr. Iluyomade says.
“Maintaining normal blood sugar levels can significantly reduce the risk of diabetes-related complications such as heart disease, kidney disease, neuropathy and vision problems,” Dr. Iluyomade says. “The benefits of improved health and reduced complications are worth the effort.”
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