Diabetes is a widespread health condition that affects 422 million people globally. Type 2 diabetes is the most common form, accounting for 90% to 95% of all diabetes cases. In the United States, approximately 1 in every 10 Americans, or about 38 million people, have diabetes, with 90-95% of these individuals having type 2 diabetes. This condition arises when your body fails to regulate the amount of sugar in your blood effectively.

Managing diabetes involves continuous effort, including monitoring blood sugar levels, following a balanced diet, and sometimes taking medication. This condition, if not managed properly, can lead to serious health issues over time, including heart disease, kidney failure, and loss of vision.

Although the idea of diabetes remission, where the symptoms of diabetes reduce to the point where medication is no longer necessary, may seem like a distant dream to many patients, research indicates that around 5% of individuals with diabetes may experience it. This fact highlights the complexity and difficulty of achieving remission and provides hope for those living with the condition.

In this article, you will learn about the concept of diabetes remission, what it means and how it is different from being cured. You’ll also discover how losing weight can help put diabetes into remission, the benefits, the different approaches to achieving it, and what you should do after achieving remission.

Key Takeaways

  • Diabetes remission is a state where individuals with type 2 diabetes can achieve normal blood glucose levels without the need for medication, as per consensus from major diabetes and endocrine organizations.
  • To achieve remission, an HbA1c level below 6.5% for at least three months without diabetes medication is considered the criteria. This highlights the importance of managing and understanding diabetes through regular blood tests.
  • Remission can lead to better control over blood glucose levels in the short term and substantial improvements in overall health and well-being in the long term, including reduced risk of diabetes-related complications. However, it is critical to understand that diabetes remission does not equate to a cure. Individuals in remission must continue to maintain a healthy diet and lifestyle to prevent the return of diabetes.
  • Losing weight, particularly around the abdomen, can significantly help put type 2 diabetes into remission by reducing fat around vital organs that manage blood sugar levels.
  • The benefits of pursuing diabetes remission include reduced risk of complications associated with diabetes, improved blood sugar levels, and a reduced need for diabetes medications, contributing to an overall better quality of life.

What Is Diabetes Remission?

A glucometer with vegetables and measuring tape around

Diabetes remission is a term used to describe the state in which individuals with type 2 diabetes have their blood glucose levels return to a normal and healthy range without relying on diabetes medication.

According to a recent consensus statement from various diabetes and endocrine organizations, including the Diabetes United Kingdom, the American Diabetes Association, the European Association for the Study of Diabetes, the Endocrine Society, and the Diabetes Surgery Summit, diabetes remission is achieved when an individual’s HbA1c level remains below 6.5% for at least three months without the use of any diabetes medicine.

HbA1c is a blood test that provides an average level of blood sugar over the past two to three months, giving a comprehensive view of how well diabetes is being managed over time. Achieving diabetes remission is highly significant for both short-term and long-term health. In the short term, it means better control over blood glucose levels without relying on medication, which can reduce the immediate risks associated with high blood sugar levels, such as hyperglycemia.

Over the longer term, it can lead to a substantial improvement in overall health and well-being. Diabetes remission has the potential to mitigate the progression of diabetes, reduce the risk of diabetes-related complications, and improve quality of life.

However, it’s important to understand that diabetes remission is not a complete cure. There’s still a risk that diabetes can return, making it crucial for individuals in remission to continue adhering to a healthy diet and lifestyle to maintain their health status. The concept of diabetes remission emphasises the possibility of reversing the effects of type 2 diabetes temporarily, but it requires ongoing effort and lifestyle management to sustain the remission state.

Why Does Losing Weight Help Put Diabetes into Remission?

Losing weight helps put type 2 diabetes into remission mainly because when people lose weight, they reduce the amount of fat stored around their important organs like the pancreas and liver. These organs play a big role in managing blood sugar levels.

When there’s too much fat around them, they can’t work properly, which can lead to high blood sugar and diabetes. By losing weight, especially around the belly, these organs can start working right again, helping to lower blood sugar levels to a normal range without needing medicine. Studies suggest that losing 15 kgs within 3-5 months can significantly increase the likelihood of remission.

What Are the Benefits of Pursuing Diabetes Remission?

A nurse is having a discussion with her male patient who has diabetes.

Pursuing diabetes remission, especially for those with type 2 diabetes, offers a range of significant benefits that can lead to improved overall health and well-being. Here’s a summary of the key benefits:

  • Reduced Risk of Complications: Achieving remission can lower the risk of diabetes-related complications such as heart disease, kidney damage, vision problems, and nerve damage. These complications are primarily driven by high blood sugar levels over time, so maintaining normal glucose levels can help prevent them.
  • Improved Blood Sugar Levels: Remission means that your blood glucose levels are within a normal, healthy range without the need for diabetes medications. This is crucial for avoiding the highs and lows associated with uncontrolled diabetes.
  • Reduced Need for Medications: Being in remission often means you can reduce or eliminate the need for diabetes medications. This not only lowers the risk of side effects associated with these medications but can also significantly reduce medical costs.
  • Lower Cholesterol Levels: Diabetes remission is associated with improved cholesterol levels, including reduced LDL (“bad”) cholesterol and increased HDL (“good”) cholesterol. This change reduces the risk of developing cardiovascular diseases.
  • Improved Blood Pressure: High blood pressure is a common issue among people with type 2 diabetes, and achieving remission can help bring blood pressure back to normal levels, further decreasing the risk of heart disease and stroke.
  • Weight Loss and Weight Management: The lifestyle changes and diet modifications often required to achieve diabetes remission can lead to significant weight loss and help with long-term weight management.
  • Enhanced Energy Levels and Well-Being: Many people report feeling more energetic and having a better overall sense of well-being once they’ve achieved remission. This can be attributed to better blood sugar control, weight loss, and a healthier diet.
  • Better Sleep Quality: Weight loss and improved blood sugar levels can also contribute to better sleep patterns, including reductions in sleep apnea, which is more common in individuals who are overweight.
  • Long-Term Health Benefits: Even if diabetes does return, the period of remission can have long-term positive effects on your health. Every year spent in remission is a year that may contribute to a reduced risk of complications.

What Are the Different Approaches to Achieve Diabetes Remission?

A healthy food option for people who have diabetes

Achieving diabetes remission involves various strategies, primarily focusing on significant lifestyle changes that lead to weight loss and improved insulin sensitivity. Here are the different approaches to achieving diabetes remission:

1. Very Low-Calorie Diet (VLCD)

This approach typically lasts for 24 weeks. During the first 12 weeks, all meals are replaced with soups, shakes, and snacks from a specially formulated diet plan, amounting to approximately 800 calories per day. In the following 12 weeks, normal food is gradually reintroduced.

It’s crucial to consult a healthcare team before starting, especially for individuals on certain diabetes medications or those with heart or kidney complications. Commercial plans like the 1:1 Diet, Exante, LighterLife, and Optifast follow this model. Additionally, the Fast800 website and the Carbs & Cals Very Low-Calorie Recipes & Meal Plans offer real food options sticking to the 800-calorie limit.

2. Low Carb Diet

This diet focuses on limiting the intake of carbohydrates, which are the body’s main source of energy but can cause blood glucose levels to rise when digested. By reducing carbohydrate intake, this diet aims to manage weight, reduce the body’s need for insulin, and lower diabetes medication requirements.

It’s recommended to discuss with a healthcare team before starting a low-carb diet, especially for those on insulin or certain diabetes medications. Resources like the Low Carb Program and the Carbs and Cals website can provide educational support and help in tracking carbohydrate content in foods.

3. Intermittent Fasting

This involves alternating periods of food restriction with normal eating. Common methods include the 5:2 diet, where you eat normally for five days and restrict calories to 500–600 for two days, and the 16:8 cycle, which limits eating to an 8-hour window each day. Intermittent fasting aims to extend the body’s fasted state, enhancing fat-burning efficiency.

Consulting a healthcare team is advised before starting, particularly for those on specific diabetes medications or with health complications. Evidence-based plans, like the ‘2-day diet’ written by dieticians, are recommended for those considering this approach.

What Does the Research Say?

Research on diabetes remission, particularly from the DiRECT trial, highlights that individuals with type 2 diabetes can achieve long-term remission through significant weight loss. The study revealed that almost half (46%) of participants could go into remission one year after following a strict weight management program, which included low-calorie diets consisting of soups and shakes. By the two-year mark, 36% remained in remission.

Extended results showed that after five years, 13% of those who continued receiving support managed to stay in remission. This means their blood sugar levels returned to a non-diabetic range without needing diabetes medications. The data suggests that achieving and maintaining weight loss is crucial for remission.

On average, participants in the weight management group had lost 5.6kg after five years, compared to 4.6kg in the control group. Those in remission by the fifth year had lost an average of 8.9kg. This research underscores the importance of weight management in controlling type 2 diabetes and indicates that even a temporary period of remission can have lasting health benefits.

What Should You Do After Achieving Remission?

After achieving remission from type 2 diabetes, it’s crucial to continue monitoring your health and maintaining a healthy lifestyle to sustain the benefits of remission. This means adhering to a balanced diet, regular physical activity, and weight management strategies to keep blood glucose levels within a normal range.

Regular check-ups with your healthcare team are essential to monitor your health status and to detect any changes early on. Continuing to attend these appointments even after achieving remission can help manage your risk of developing diabetes in the future and maintain significant health benefits such as lower blood glucose, blood pressure, and cholesterol levels.

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Conclusion

In conclusion, diabetes remission is a hopeful goal for those with type 2 diabetes. It means getting your blood sugar back to normal without needing medicine. While not a cure, remission can lead to better health and fewer risks of serious problems. Losing weight, especially around vital organs, plays a big role in achieving this. The benefits of remission include less risk of complications, stable blood sugar levels, less need for medication, and better cholesterol levels. Remember, it’s about making lasting changes to your lifestyle to keep diabetes in check.

FAQs About Diabetes Remission

What is the difference between diabetes reversal and remission?

Diabetes reversal and remission are two terms that are often used interchangeably, but they actually have slightly different meanings. Remission means that your blood sugar levels are normal without the need for any medication, while reversal means that your medication dosage has been reduced.

Can diabetes stay in remission forever?

Even if you are in remission, there is always a chance that the symptoms of diabetes will return. However, some people can go years without any trouble controlling their blood sugar levels and managing their diabetes.

Will diabetes come back after remission?

Remission is not a one-time event, and it needs to be maintained. There’s always a chance that diabetes may return, so it’s important to keep a watchful eye on your weight, eating habits, and activity levels. If you notice any changes, seek extra support to make adjustments and stay on track.

Sources

New York City Department of Health and Mental Hygiene. (2023). Diabetes Remission. NYC Health. https://www.nyc.gov/assets/doh/downloads/pdf/diabetes/diabetes-remission.pdf

MyWay Digital Health. (2024, February 22). Diabetes Remission. MyWay Diabetes Somerset. Retrieved from https://somerset.mydiabetes.com/resources/internal/diabetes-remission/

Diabetes UK. (2024, February 26). Weight loss can put type 2 diabetes into remission for at least five years, direct study reveals. Retrieved from https://www.diabetes.org.uk/about-us/news-and-views/weight-loss-can-put-type-2-diabetes-remission-least-five-years-reveal-latest-findings