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Reversal of Diabetes: Myths Busted

Reversal of Diabetes: Myths Busted

 "Around 68% of diabetics aged 65 or older die of heart disease." 


Diabetes is a dynamic disease. If one does not control it properly, they will move from normal glucose tolerance to pre-diabetes, diabetes, and other related health complications. The reversal of diabetes is going in the opposite direction. If you start with diabetes, you can revert to pre-diabetes. From there, you can go to normal glucose tolerance or normal blood sugar levels. 

Reversal of diabetes is important because, the last stage of diabetes causes several health complications where your kidneys, eye sight, and nerves are affected, and your feet are affected. Can you reverse the complications? Reversal of complications is not possible for everyone; it is a bit too late for most.

Is diabetes reversal different from diabetes remission?

Diabetes reversal is a word not often used by doctors as this might sound like a permanent reversal. But there is no guarantee that your diabetes has gone forever. However, it is possible to put type 2 diabetes into remission.

We do not call it diabetes reversal, as it might sound like a permanent reversal. There is no guarantee that your diabetes is gone forever. But, it may be possible to remit your diabetes.

Remission means you should be in a non-diabetic stage as far as your blood glucose and HBA1c are concerned. Your diabetes is said to be in remission when your HBA1c is below 5-6%, and fasting blood sugar is below 100 mg/dL. The 2-hour value in the glucose tolerance test (postprandial blood sugar) is below 140 mg/dl without any medications.

How to reverse type 2 diabetes?

In the stage of clinical diabetes, it is possible to reverse your diabetes. Almost always, this reversal of diabetes is associated with weight loss. The strongest evidence there is at the moment suggests that remission of type 2 diabetes is mainly by weight loss. The chances of remission are high if you lose weight immediately after your diabetes diagnosis.

Weight gain after age 18 years is a major determinant of type 2 diabetes. A weight gain of just 5 to 8 kg increases the risk of type 2 diabetes by 90%, and a weight gain of 8.0 to 10.9 kg increases the risk by 270%.

If you are obese, diabetes remission is possible if you lose a substantial amount of weight (around 15 kg) as quickly and safely as possible. But not everyone who loses this much weight will be able to put thier diabetes into remission. However, losing weight can also help better blood sugar levels, fewer medications, and lower complications.

Even 2 grams of fat in the pancreas is enough to produce diabetes. Once these 2 grams of fat is removed (generally through a weight loss of about 15-20 kilograms), your diabetes reversal occurs. In the process, the amount of fat in your liver will also come down significantly. But there are certain conditions. You can lose this 15 kg weight in 2-3 months, but you must maintain it at that level. Your diabetes may come back again if you put back 10 kg.

The shorter the duration of diabetes, the easier the remission is; for example, the reversal could be possible if you have diabetes for less than 10 years. As this duration goes beyond 15 years, your pancreatic beta-cell function go-down so low to the point that reversal may be challenging.

How about type 1 diabetes reversal?

When you talk about diabetes remission, you are always talking about type 2 diabetes, not type 1 diabetes or other types of diabetes. Type 1 diabetes is a chronic condition where the pancreas produces very little or no insulin.

Some non-physicians create a big hype about diabetes reversal; they even promise children with type 1 diabetes could also be reversed. But very rarely, type 1 diabetes in a child is completely reversed. No reversal is possible in type 1 diabetes; you must continue insulin throughout life. 

There are also other types of diabetes, like Fibrocalculus pancreatic diabetes, which cannot be reversed.

Diet for type 2 diabetes

To help manage your diabetes: 

  1. Make sure you do not starve yourself and deprive the body of vital nutrients it needs
  2. Eat a healthy, well-balanced, low-carbohydrate diet
  3. Add exercise to the weekly schedule and lose excess weight

Have a long-term diet and exercise plan. If you have a 10-year plan and maintain your diet and exercise, then go ahead. If your goal is for three months, do not do it because your body will get confused, and immunity will go down with too many weight loss attempts and weight gain, creating a "Yo-Yo effect". Such attempts will upset the metabolism in your body and could lead to more complications.

Similarly, your fat content could go up significantly when you take a very low carbohydrate diet; you may have a heart attack due to very high lipids. You must be careful with diet restriction; without proper supervision, it can also lead to death. Please consult a doctor or qualified dietician who could advise you on a safe way.

Bottom line

Diabetes and obesity go hand in hand. Weight loss is the most crucial factor in reversing type 2 diabetes, as extra fat in the body affects insulin secretion and how it is used.

The shorter the duration of diabetes, the easier it is to achieve remission. Eat a healthy, well-balanced, low-carbohydrate diet.

Take advice from your doctor before making significant changes to your diet, and have regular blood checks. Add exercise to the weekly schedule and lose excess weight. Have a long-term plan and be patient till you achieve your desired results. 

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