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Can diabetes be reversed and possibly cured?

To answer these two questions correctly, we need to delve a little deeper into the subject. There are actually only two diagnostic codes for diabetes, namely one for type 1 and one for type 2. Under these two diagnoses, there are more than 30 subtypes, each with different causes and characteristics.

Can diabetes be cured?

If you ask generally "can diabetes be cured", the answer is YES, as several of the subtypes can be cured, including the most common type 2 diabetes (due to insulin resistance) in some cases.

  • Gestational diabetes often disappears after childbirth.

  • Medication-induced diabetes often disappears when the medication is stopped.

  • Secondary diabetes, such as due to pancreatic disease, disappears if the pancreas is cured.

  • Common type 2 diabetes can be cured with gastric operations.

  • Common type 2 diabetes can in some cases be cured with weight loss, especially if the disease hasn't been present for long.

Type 1 diabetes can actually also be cured with an artificial pancreas, but this is still only on a trial basis, so I'll disregard that here.

... and yes, I know that some of the types will still be at risk afterward, such as gestational diabetes, but that doesn't change the fact that they were cured initially. All diseases can return, even if cured. So possible curing depends on the type of diabetes and the duration one has had it.

Can type 2 diabetes be reversed/put into remission?

Remission and reversal mean "bring back, reduce, disappear."

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) is the group of nutrition experts who develop guidelines for EU countries on diet for diabetics, and Denmark, including the Diabetes Association, follows these guidelines. In the panel's latest report, which now forms the basis for revising the dietary guidelines for diabetics, much text is used to explain remission and the good possibilities of reversing diabetes, especially through weight loss.

Because, of course, type 2 can be reversed. We've known this for several years, so it's great that the official system has now also recognized it.

The official term for achieving remission is when one's HbA1c is below 48 for at least three months without taking diabetes medication. So remission is not the same as being cured of diabetes, where the disease disappears completely.

What can reverse type 2?

There are several interventions that can reverse type 2 diabetes, especially:

  • Weight loss

  • Fasting

  • Eating fewer carbohydrates

  • Gastric operations

  • Exercise, lots of it

So considering diabetes generally as a "chronic and progressive disease" is incorrect. Most doctors (yet) only know that the disease slowly worsens with more and more medication to follow, and therefore they consider it to be chronic and progressive, but many new studies and trials challenge this claim.

Try to imagine these two different scenarios when diagnosed by the doctor:

Scenario 1:

"You have unfortunately been diagnosed with type 2 diabetes, and it is a disease that only worsens over time, and unfortunately we cannot do anything about it. The good thing is that we can keep the symptom, high blood sugar, down with medication, and ultimately we can give you insulin. You have a fairly high risk of complications over the years, but we do what we can with the medication, and you should eat according to the official dietary guidelines."

Scenario 2:

"You have unfortunately been diagnosed with diabetes, but the good thing is that the disease can be kept down and dormant for many years and maybe for the rest of your life. It requires some lifestyle changes, but we have a treatment plan ready that can help you get started and provide you with the necessary support, learning, and knowledge. The program includes learning about weight loss, more diabetes-friendly diet, meal times, and exercise. If you participate in this program, there is a good chance that you will never experience complications of the disease."

Scenario 1 pretty much resembles the current diagnosis meetings with the doctor, while scenario 2 can and should be the scenario that will be implemented in the future in the Danish healthcare system for the treatment of type 2 diabetes, and therefore it's good that DNSG/EASG now also includes this aspect in their new recommendations for treating diabetes with diet and weight loss.

Feel free to comment on my presentation... including disagreements.

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