There is a conversation taking place regarding reversal vs. remission vs. cure of diabetes. This is referring to type 2 diabetes; however, that is not always made clear in the media. I read about one mom’s frustration with questions and messages about her son “outgrowing” his (type 1) diabetes. Not until there’s a cure. There is an article discussing a consensus among diabetes experts on this subject.
I have had many patients – with type 2 diabetes – ask if they can get rid of it. I always explain that by making healthy food choices, exercising, managing their stress and losing weight they can get their blood glucose level down. Once their numbers are consistently in the “normal” range (70-110 mg/dL before meals and less than 140 mg/dL 2 hours after meals) they will feel better, have a greatly reduced risk of long-term complications, and they will appear to not have diabetes. However, diabetes is still lurking there: if they were to return to their old habits/lifestyle, their numbers would go right back up.
The article linked above discusses the “remission” of diabetes after gastric bypass/banding. It is very common for diabetes to go away after someone has this type of weight loss surgery. If the person follows a healthy lifestyle consistently – healthy eating and regular exercise – they can keep their blood glucose levels down. Unfortunately, even in these people, returning to unhealthy eating habits and/or lack of exercise can land them back in diabetes-ville. I’ve had patients for whom this has happened.
Healthcare professionals historically used the term, “borderline” to describe what is now called “pre-diabetes”. To those of us in the field, this means type 2 diabetes is knocking on the door, and without sufficient lifestyle adjustments (changes), it’s going to come right in. We no longer say “borderline”, because people just didn’t take it seriously. How many times have you heard someone say, “I’m just borderline. I don’t have to worry about it.” Just as type 2 diabetes can be prevented with a healthy lifestyle, diabetes remission can be prolonged the same way. Regardless, I think it’s risky to call this a “cure” or even “reversal”. I worry that people might truly believe it’s gone, whereas even “remission” implies that it could come back. What do you think?