Can T2D be reversed?

Purvishd

cwolfman13

Yes

It can be reversed and put into remission, but not cured.

AnnPT77

It depends on what you mean by "reversed", maybe?

Quite a few people here have reached a state where they no longer need medication to maintain normal blood sugar levels (and A1C). I think that's more "remission" than "reversed".

paperpudding

No

My vote is no.

Some people can reduce their need for medication, sometimes to nil, with weight loss and dietary changes.

But it is not reversed - it is kept under control by diet and maintaining weight loss.

I wouldn't call that reveral or even remission. I would call it diet controlled diabetes.

If you were to stop adhering to the diet and/or were to regain the weight, the blood sugar control would need medication again.

gillianboreland83

Yes

You could say yes it can be reversed as it’s gone in the opposite direction to what it was heading. I am T2D. I have lost 5 stone and my diebetes has reversed and in remission. My life style change has completely reversed and I no longer need medication for diebetes. As long as I keep up with what I am doing my diebetes will not revert back to needing medication and in the danger zones. People also need to realise that once you have diebetes you have it, it does not disappear so when you do get it under control, don’t believe you are back to normal and can stop what you have been doing to put it in remission or it will come strait back to bite you in the backside. The lifestyle change has to be forever.

paperpudding

No

so, it seems everyone is saying basically the same thing, despite no and yes votes

Which probably means people have different ideas of 'reversed', rather than they think different things.

Dante_80

No

T2D is a lifelong, incurable disease. Through diet changes and weight loss, you may be able to reach and hold normal blood sugar levels without medication. That is not "reversing" it though, it is simply controlling it.

xrj22

Yes

For those of you saying that t2d is only "in remission" and not reversed ie "cured": then does that mean there an millions of thin healthy people who "have" diabetes but just dont know it because they would develop diabetes if they ate poorly and gained weight? My understanding is that for many people the underlying metabolic disorder of insulin resistance DOES correct over time, insulin levels go down, response to dietary carb normalizes so that they metabolize sugars more normally. It isnt just that they are keeping blood sugar low by not eating sugars.

SuzanneC1l9zz

That's like saying millions of people "have" heart disease and don't know it because they'd develop it if they drastically increased their saturated fat intake and took up smoking.

In either case, they don't "have" it, they "would develop it, IF...."

paperpudding

No

xrj22 wrote: »

For those of you saying that t2d is only "in remission" and not reversed ie "cured": then does that mean there an millions of thin healthy people who "have" diabetes but just dont know it because they would develop diabetes if they ate poorly and gained weight? My understanding is that for many people the underlying metabolic disorder of insulin resistance DOES correct over time, insulin levels go down, response to dietary carb normalizes so that they metabolize sugars more normally. It isnt just that they are keeping blood sugar low by not eating sugars.

No it doesnt then mean that.

Not sure how you are reaching that conclusion.

It means once type 2 diabetes has developed - ie your pancreatic function has deteriorated to that level - it does not regain the lost function.
But if you stay a healthy weight and eat correctly, your blood sugars can stay at a healthy level and you may not need medication.
What some people are calling remission - It isnt remission as I understand the word, more diet controlled.

Perhaps more like somebody who has had a heart attack, ie already has heart damage rather than would develop it - the damaged heart muscle does not re grow but they can be healthy if they manage their condition well.

mlrtri

I have not done a lot of research so this is a question. If a person doesn’t have a problem with the pancreas producing insulin and their problem is more with insulin resistance and they do things to improve their body’s insulin sensitivity then wouldn’t that be considered reversing T2D?

MaggieGirl135

I recently read this article at medscape.com, which addresses this issue.

https://www.medscape.com/viewarticle/963547

When I read the article I thought of hysteresis, although I don't believe this word is used in the article. Meaning, you can't go back to your original 'state', prior to having T2D, although your new 'state' could be similar to the original one. I may be using this word incorrectly for human biological processes; I have only used the word in association with electrical devices.

This website is intended for health care providers, but anyone can sign up, if the article cannot be read without signing in.

nsk1951

No

I'm saying NO ... because the word 'reversed' implies that it is gone. TD2 can be managed ... and those results will only last as the managing part stays tight and constant.

mlrtri

I don’t know about using the terms reversed, cured, etc. What I do know is that there are things you can do to improve your metabolic function by losing weight and eating to protect your liver and improve the health of your cell mitochondria. You should definitely do this. Many are able to get off of medication by changing their lifestyle. Is that cured? Reversed? To me it doesn’t matter. Improved health is improved health. A win either way.

Onedaywriter

Yes

The medical definition is that not only are the symptoms gone, but the damage the disease does to the body is also cured.

For a person who has T2 for a long time and develops other issues from it eg retinopathy or neuropathy- it cannot be reversed. But for someone who modifies their lifestyle quickly after developing T2 it can be reversed. Abnormal insulin resistance can be changed.

boberg1239

"It means once type 2 diabetes has developed - ie your pancreatic function has deteriorated to that level - it does not regain the lost function."

Most type 2 diabetes is caused by "insulin resistance" meaning the insulin has a diffcult time getting the serum glucose into the cells so that it can be used properly by the organ for energy. Some indivduals may have injury to the pancreas but that is not the most common cause of type 2 diabetes....insulin resistance is.

There are many scientific studies and data to show that a diet which causes significant weight loss (10% of original weight or better), therefore a decrease in fat, including visceral fat and intracellular fat that is in the cells will decrease insulin resistance and therefore allow insulin to do its job better making the person more insulin sensitive. These changes can result in normalizing hemoglobin A1C and fasting glucose levels. If the person puts the weight back on they are very likely to experience the same problems as before the weight loss.

Here is the definition from the ADA website for remission: “remission” = HbA1c <6.5% (48 mmol/mol) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion.

neanderthin

Yes

"boberg1239;c-46953361

Here is the definition from the ADA website for remission: “remission” = HbA1c <6.5% (48 mmol/mol) measured at least 3 months after cessation of glucose-lowering pharmacotherapy as the usual diagnostic criterion.

I find the ADA's definition quite strange for remission to be < 6.5% when 6 is considered pre diabetic. Not my idea of remission in any sense of the word.

lcoulter23

It can be managed and put into remission, but it can't be cured. Just like Polycystic ovarian syndrome (another endocrine disease that goes along with insulin resistance & prediabetes) it can be managed & put in remission but it never truly goes away and anything can trigger it to come back. Stress, a hormone fluctuation, etc. This goes for T2D as well. My mom is type 2 diabetic and I have PCOS. She was also a nurse for over 30 years and I've done extensive research on both topics since they affect my family's life greatly.

neanderthin

Yes

lcoulter23 wrote: »

It can be managed and put into remission, but it can't be cured. Just like Polycystic ovarian syndrome (another endocrine disease that goes along with insulin resistance & prediabetes) it can be managed & put in remission but it never truly goes away and anything can trigger it to come back. Stress, a hormone fluctuation, etc. This goes for T2D as well. My mom is type 2 diabetic and I have PCOS. She was also a nurse for over 30 years and I've done extensive research on both topics since they affect my family's life greatly.

lcoulter23 wrote: »

It can be managed and put into remission, but it can't be cured. Just like Polycystic ovarian syndrome (another endocrine disease that goes along with insulin resistance & prediabetes) it can be managed & put in remission but it never truly goes away and anything can trigger it to come back. Stress, a hormone fluctuation, etc. This goes for T2D as well. My mom is type 2 diabetic and I have PCOS. She was also a nurse for over 30 years and I've done extensive research on both topics since they affect my family's life greatly.

Very true. It's amazing the amount of dysfunction and chronic diseases that you wouldn't think have metabolic origins but nope too much insulin (hyperinsulinemia) is the 900 lb gorilla. Basically with PCOS it's the lack of that big estrogen spike which is needed preceeding ovulation and too much insulin blocks the ovaries that allow that estrogen surge. All cases of PCOS the person will have hyperinsulinemia. The recovery from PCOS is fairly reliable when IR or diabetes is managed properly.

BartBVanBockstaele

No

I cringe when I hear/read the word "reversed". "Reversed", to me, is the restoration of a previous situation. That is impossible. Biology goes forward, not backward. All you can do is attempt to advance (not reverse) to a state where the problem has no (longer any) influence.

Think of the difference between a thin plank and a thick one. The thick one is able to carry more weight. However, the thin one will perform just as well as the thick one if you don't put much weight on it.

Something similar goes on with diabetes: you can, often but far from always, manage your system into a condition where a weakened pancreas can adequately do all the work it needs to do. That means the situation is well-controlled. The damage/inadequacy is still there but it is unimportant because better/more functionality is not required. However, the moment you go over the limit of what the pancreas can handle the high blood sugars reappear. On top of that, it is quite possible that the pancreas continues to deteriorate even while the situation is under control and therefore further reduces the condition the pancreas can handle, until it no longer can handle situations that were "well-controlled" before.

As a result, I would use the term "under control" and possibly the therms "in remission" and "cured" if the situation remains stable for a long time, but most definitely not "reversal". There cannot be reversal of damage, only (possibly) more or less good repair if one is very lucky.

Daddy78230

Yes

I’m a T2D, in remission - controlled by lifestyle changes.

When I was diagnosed several years, I was told that my diabetes and the neuropathy of my liver, feet and leg was irreversible and will progressively get worse unless I manage it with medication and conventional diet (high carb low fat). The best I could hope for was for my condition to be stabilized.

However, after a couple years of trying the doctors way and getting worse, I tried many of the unconventional methods of controlling diabetes (fasting, low carb). I was able to bring my blood sugar back to health ranges, HbA1C from 7.8 to 4.7 within 6 months. Neuropathy took a few years to reverse itself, restored all the sensation of all my body parts. Kidney function is back to normal.

Though my symptoms have reversed itself, and I have a higher tolerance for carbs - I’m not cured. I’ve tried to include more carbs in my diet for a year, but my HbA1c kept creeping up regardless of maintaining my weight.

neanderthin

Yes

Daddy78230 wrote: »

I’m a T2D, in remission - controlled by lifestyle changes.

When I was diagnosed several years, I was told that my diabetes and the neuropathy of my liver, feet and leg was irreversible and will progressively get worse unless I manage it with medication and conventional diet (high carb low fat). The best I could hope for was for my condition to be stabilized.

However, after a couple years of trying the doctors way and getting worse, I tried many of the unconventional methods of controlling diabetes (fasting, low carb). I was able to bring my blood sugar back to health ranges, HbA1C from 7.8 to 4.7 within 6 months. Neuropathy took a few years to reverse itself, restored all the sensation of all my body parts. Kidney function is back to normal.

Though my symptoms have reversed itself, and I have a higher tolerance for carbs - I’m not cured. I’ve tried to include more carbs in my diet for a year, but my HbA1c kept creeping up regardless of maintaining my weight.

Daddy78230 wrote: »

I’m a T2D, in remission - controlled by lifestyle changes.

When I was diagnosed several years, I was told that my diabetes and the neuropathy of my liver, feet and leg was irreversible and will progressively get worse unless I manage it with medication and conventional diet (high carb low fat). The best I could hope for was for my condition to be stabilized.

However, after a couple years of trying the doctors way and getting worse, I tried many of the unconventional methods of controlling diabetes (fasting, low carb). I was able to bring my blood sugar back to health ranges, HbA1C from 7.8 to 4.7 within 6 months. Neuropathy took a few years to reverse itself, restored all the sensation of all my body parts. Kidney function is back to normal.

Though my symptoms have reversed itself, and I have a higher tolerance for carbs - I’m not cured. I’ve tried to include more carbs in my diet for a year, but my HbA1c kept creeping up regardless of maintaining my weight.

Yeah, unfortunately carbs will not be your friend, ever. Good job for taking your own health into your own hands because the standard of care is medication. Personally, I feel really bad for the many people that were prescribed insulin for injection.......what were they thinking, it makes me really wonder how that could have ever been an option to begin and still is. Good luck.

1r1shayes

Yes

My doctor explained it this way. Reversed means you have changed directions. Diabetes is progressive, if we do not change things. I have reversed my diabetes by cutting out foods that were literally poisoning me. In doing so, I've stopped all my diabetic meds (three of them), narrowly avoiding insulin, and have maintained an A1C of 4.7 for 3+ years. If a doctor who did not know my history were to look at my labs, he would not know I was diabetic. That's reversed. Now, I will never be cured. If I were to go back to eating hella carbs, all my health issues would come back. But yes, I'm reversed.