Signs of Type 2 Diabetes Remission
Diabetes is a chronic, progressive disease with no known cure. With proper care, however, it can be controlled. Control for an extended period of time - without medication - is considered to be remission.
Diabetes is defined as a blood glucose level of 126 mg/dl or higher, or an HbA1c number of 6.5 percent or higher on two consecutive tests.
Pre-diabetes is diagnosed when blood glucose tests between 100 and 125 mg/dl and HbA1c is between 5.7 and 6.4 percent.
Normal sugar levels are 99 mg/dl or lower, and HbA1c lower than 5.7 percent.
Treatment consisting of a healthy diet, weight loss, exercise and medication can bring pre-diabetes to normal, or recently diagnosed diabetes to either pre-diabetic or normal levels.
If normal glucose levels can be maintained for one year without medication, the patient is considered to be in “complete remission.” The patient should continue to be checked for glucose and cholesterol levels, blood pressure level and kidney, eye and foot problems on a regular basis.
Normal glucose levels sustained for five years mean the patient is considered to be in “prolonged remission.” Lab tests may occur less frequently at this point, but the health issues noted above should continue to be monitored.
Anyone who achieves remission is at an elevated risk for relapse. Remission is most likely in the early stages of diabetes or after a substantial weight loss.
Once in remission, there is evidence that the body can repair some of the damage caused by diabetes. The damage that appears to be most reversible is neuropathy in the feet. Other damage that appears to be reversible to some degree includes sexual dysfunction, retinopathy (eye disease) and nephropathy (kidney disease).
Damage that has progressed beyond certain levels is likely permanent, although some degree of improvement may occur. For instance, someone who is blind or is experiencing kidney failure will not regain function back to pre-disease levels.
The Impact of Bariatric Surgery on Remission
Bariatric surgery, including gastric bypass and gastric banding, can result in substantial weight loss. The procedure itself, however, often causes the patient to go into remission, even before any weight is lost. Researchers believe that the surgery affects gut hormones, which impact the pancreas and the production of insulin.
Anecdotes or Science?
It is said that most of the evidence of remission is anecdotal, that there are no scientific studies that have proven this is possible. That is not entirely true. There have been numerous small studies, but no large-scale test of the possibility of remission.
In part this is because the change required to achieve remission is hard to achieve, and not everyone is capable of making these changes. Dietary control has to be rigorous and the changes made permanent. Exercise must be made a part of everyday life. Finally, these changes must take place early in the disease process, before too much damage has occurred.
For those who are willing and able to integrate these changes into their life, prolonged remission is a great reward.
Photo courtesy: NCI / Rhoda Baer