What is Diabetes Reversal ? Can everyone reverse their diabetes ?
“Diabetes reversal”: this word should not be used. It’s actually Diabetes Remission.
Diabetes remission is applicable only in Type 2 diabetes. When a person with it, is able to bring down HbA1c below 6.5 % and maintain it for 3 months without any medications for diabetes, technically it is called as remission of diabetes.
This does not mean that diabetes went away or cured. Absolutely not. Diabetes will be there but its under remission. If lifestyle management factors (diet, exercise, stress, sleep etc) are deranged then there will be an increase in blood sugar and HbA1c becomes more than 6.5 and the person with diabetes may required medications.
Clinically, type 2 diabetes is heterogenous and it exists differently in different individuals with varying causes and severity of insulin secretory defects and insulin resistance.
Persons with long standing type 2 diabetes (> 10 yrs), established complications of diabetes and with comorbidities, are possibly unsuitable candidates for a diabetes remission programme.
In landmark clinical studies done in UK, it has been clearly shown that diabetes remission is not for all with diabetes and has been achieved in patients with relatively shorter duration of diabetes (less than 6 years from the time of diagnosis of type 2 diabetes) with optimum C-peptide levels (optimum insulin secretion from pancreas), following a low caloric diet achieving 10-15 % weight loss.
Point to be noted here that with weight regain, the blood sugar levels will increase, requiring medications.
Remission must be discussed with the treating Diabetologist / Physician and should be attempted only under expert medical guidance.
By Dr Surajeet Kumar Patra, MBBS, MD, F DIAB
Director & Consultant Diabetologist, Dr Surajeet Patra’s Diabetes clinic, Bhubaneswar
