Our grateful thanks to Nusrat Kausar from Primary Care Dietitians for her contribution to our radio report which you can hear again via the audio player at the bottom of this page. Our thanks also to Diabetes UK for the use of the information below.
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Diabetes remission in people with type 2 diabetes means that your blood sugar levels are below the diabetes range without needing to take any diabetes medication.
People with type 1 diabetes cannot put their diabetes into remission though scientists are working hard to discover how this might be possible and to develop new treatments. Some people with type 1 can start to produce some of their own insulin again with islet transplants.
Is remission a cure for type 2 diabetes? There isn't enough evidence that remission is permanent. It needs to be maintained and in many cases, blood sugar levels can rise again, which is why it is so important to continue your diabetes appointments while in remission.
How you can put diabetes into remission? The strongest evidence suggests that diabetes is mainly put into remission by weight loss.
If you live with obesity or overweight, you are more likely to put your diabetes into remission if you lose a substantial amount of weight – 15kg (or 2 stone 5lbs) – safely and as quickly as possible following your diagnosis.
If you do want to start losing weight quickly to work towards remission, it's important to talk to a healthcare professional before you begin, to make sure it’s right for you. Also, you may need to reduce or stop any medications – insulin or sulphonylurea, for example – before you begin losing weight.
Rapid weight loss is not advised if you are a healthy weight, under 18, pregnant, breastfeeding or have ever been diagnosed with an eating disorder.
How losing weight help put your diabetes into remission. To understand how losing weight can help someone go into remission, we need to understand why obesity or overweight can lead to type 2 diabetes.
If someone’s carrying extra weight around their middle, fat can build up around important organs like the liver and pancreas. This makes it more difficult for those organs to work properly, leading to type 2 diabetes.
But not everyone who develops type 2 diabetes lives with obesity or overweight. There are other factors, like age, ethnicity and family history that play a role in our risk of type 2 too. These factors influence how well the liver and pancreas work, and also where we store our fat.
We can’t change those things, but we can usually change our weight.
Scientists believe that just as storing fat around the liver and pancreas affects how type 2 develops, losing fat affects remission. They want to find out if it can help the liver and pancreas to start working properly again.
Weight loss has many benefits, even if it doesn’t lead to remission. People with obesity have an increased risk of serious health conditions, includiing heart attack, stroke and certain cancers. Research has shown that losing just 5% of your body weight can:
Can anyone with type 2 diabetes go into remission? There’s lots experts are trying to trying to understand. such as how or whether every person with type 2 diabetes can go into remission.
Remission is more likely if you lose weight as soon as possible after your diabetes diagnosis. But, some people have put their diabetes into remission 25 years after being diagnosed.
Does being in remission prevent future complications? By being in remission, you’re keeping your blood sugar levels below the diabetes range. Losing weight and being in remission also helps to keep your blood pressure and cholesterol down.
Having blood sugar, blood pressure and cholesterol levels in a healthy range is usually linked to a lower risk of complications, such as serious problems with your eyes, feet or heart. So, remission is likely to do the same.
However, enouhg is not known to say confidently that remission leads to reduced complications. That is why its recommended that people attend regular health checks even when they are in remission and blood sugar levels are healthy – to ensure that any new, or existing complications, can be monitored and treated properly.
Is remission permanent? Diabetes UK have reports of people who have been in remission for up to 15 years. However, even if you are in remission, it is always possible that your blood sugar levels could come back into the diabetes range.
Remission is not a one-off event, but a process. It needs to be maintained, and the best way to do that is to keep to a healthy weight and stay active.
Staying in remission. Remission is not a one-off, once-and-for-all event. It needs to be maintained, because there’s always a chance that your diabetes might return.
So, you need ongoing support to keep an eye on your weight, and if it starts to creep up again, ask for extra support to adjust your eating pattern and activity levels.
How can I get started? So far, there is strong research evidence for two approaches that can lead to remission. Both involve losing a significant amount of weight fairly rapidly. One is to follow an intensive, low-calorie weight-loss programme of around 850 calories a day. The other approach is weight-loss or bariatric surgery, which helps you to feel full quicker and so helps you to reduce the amount you eat.
But while these are the approaches with the best quality research to put your type 2 diabetes into remission, there are other, more gradual approaches. We know that some people in remission got there by losing weight through the Mediterranean diet or a low-carb diet. Everyone’s different and what works for some may not for others.
You should ask your diabetes team for help with weight loss.They’ll be able to see if there’s a weight management service in your area, where you’ll get support and advice from a dietitian. Whichever approach you consider, it’s important to seek support from your healthcare team. Wondering where to begin? Use our food tool to get started.
Weight loss surgery for diabetes remission. Diets aren’t the only way people with type 2 diabetes have gone into remission – some have had bariatric or weight-loss surgery. One study found that almost a third (30.4%) of people who had surgery were in remission after 15 years.
Surgery is no quick fix, but it should be an option for those who want it. At the moment, it can be really difficult to get a referral. So we’re working to try and make bariatric surgery more accessible for those who fit the criteria.
If you’re in diabetes remission. Because your blood sugar levels may go back into the diabetes range even if you have been told you’re in remission, you should keep going to your regular check-ups. If you’re worried about anything or have any questions, talk to a member of your healthcare team.
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