November is National Diabetes Awareness Month and while there’s a usually a focus on diabetes and prediabetes prevention, many people still face the burden of a diabetes diagnosis. (Montri Thipsorn, Shutterstock)
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SALT LAKE CITY — Did you know that 10.5% of the U.S. population has diabetes? That’s according to the Centers for Disease Control and Prevention, and the numbers are rising each year.
November is National Diabetes Awareness Month and while there’s a usually a focus on diabetes and prediabetes prevention, many people still face the burden of a diabetes diagnosis.
After being diagnosed with Type 2 diabetes, some people might ask the question, “How can I get rid of my diabetes?” The answer isn’t so clear cut.
Can Type 2 diabetes be reversed?
Can people with Type 2 diabetes get rid of or reverse the disease? In short, not exactly.
However, a small percentage of people with Type 2 diabetes can attain normal blood glucose (sugar) levels, or normoglycemia, particularly if they had bariatric or metabolic surgery or lost a significant amount of weight, according to a 2019 study.
With Type 2 diabetes, the cells that produce insulin, called beta cells, stop working properly. There’s usually insulin resistance, meaning the cells in your body don’t respond well to insulin and can’t use the glucose from your blood for energy.
Going into diabetes remission may help the beta cells start working again, increasing insulin sensitivity. The chances of helping the beta cells regain some normal function are best in the early stages after a diagnosis of Type 2 diabetes.
Still, over time, blood glucose levels may rise again, especially if poor lifestyle habits return and weight is regained. This is why diabetes isn’t considered “cured” or reversed.
What is the right term to use when someone with Type 2 diabetes attains normal blood sugar levels?
In August 2021, a joint consensus statement was issued by the American Diabetes Association, the Endocrine Society, the European Association for the Study of Diabetes, and Diabetes U.K.
This consensus statement acknowledged that there is no standardized term or definition to describe the rare occurrence of extended normoglycemia in people previously diagnosed with Type 2 diabetes who are not using glucose-lowering medications.
Terms like “reversal” or “cure” are often used in these circumstances, but are sometimes associated with controversial claims. The new standardized term is “remission.”
How is diabetes remission defined?
Hemoglobin A1C is a blood test used to measure your average blood glucose levels over the past 3 months. Doctors frequently use the A1C to diagnose diabetes, as well as to see how well someone is managing their diabetes.
The joint consensus statement defined diabetes remission as an A1C level of less than 6.5% for at least 3 months without the use of glucose-lowering medications. This applies whether achieved through lifestyle changes, metabolic surgery or other means.
When A1C is not a reliable marker of glycemic control due to certain health conditions, a fasting glucose level of less than 126 mg/dL or an estimated A1C level of less than 6.5% calculated from continuous glucose monitor values can be used.
The importance of regular health exams
Even when someone is considered in remission, it’s important to still get regular glucose testing done because high blood glucose levels can come back.
Risk factors that increase this possibility include poor eating habits, not being physically active, weight gain, taking certain medications that can increase blood glucose levels or having high levels of stress from another illness.
Even after remission, the classic complications of diabetes including retinopathy (disease of the retina), nephropathy (kidney disease), neuropathy (nerve damage), and risk of cardiovascular disease can still happen due to something called metabolic memory.
Because you might not notice the symptoms of elevated blood sugars at first, it’s important to still get a regular (at least yearly) health exam by your health care provider that includes an eye exam, kidney function tests, foot exam, blood pressure measurement and HbA1c test.
Staying in remission
Staying in Type 2 diabetes remission is not a one-time goal you achieve. It is a lifelong journey. Whatever means you used to achieve remission, you must maintain and continue. If not, the inflammation and insulin resistance that caused Type 2 diabetes in the first place can easily return.
Some ways to help someone stay in remission while also providing numerous other health benefits include:
- Making healthful food choices
- Staying physical active
- Maintaining a healthy weight
- Practicing self-care
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